Coronal or swinging eyelid decompression for patients with disfiguring proptosis in Graves' orbitopathy? Comparison of results in one center.
OBJECTIVE
To compare 2 different approaches for 3-wall orbital decompression in patients with disfiguring proptosis due to Graves' orbitopathy, and to determine which technique is preferable.


METHODS
Retrospective nonrandomized study with a concurrent comparison group.


METHODS
Charts of 74 consecutive patients with disfiguring proptosis due to Graves' orbitopathy who underwent coronal (46) or swinging eyelid (28) decompression between January 1, 2000 and January 1, 2004 were studied retrospectively. Patients with dysthyroid optic neuropathy were excluded.


METHODS
We analyzed the following parameters: proptosis reduction, ocular motility, number of additional operations, number and kind of complications, patients' satisfaction, patients' estimation of numbness or abnormal sensations in the field of operation and surgical scars, and duration of hospitalization time.


METHODS
Reduction of proptosis, changes in eye motility, and duration of hospitalization.


RESULTS
Mean proptosis reductions were 4.8 mm (range, 1-11) after coronal decompression and 5.6 mm (range, 0-8) after swinging eyelid decompression (P = 0.025). Patients who were operated by the swinging eyelid approach had no more deteriorated motility and a shorter hospitalization time. Complications were seen rarely. Both groups of patients showed high satisfaction scores.


CONCLUSIONS
Relative to the coronal approach, swinging eyelid decompression results in at least the same proptosis reduction, no greater motility disturbance, and a shorter hospitalization time.
Sasim
Inna V
IV
Division of Ophthalmology, Department of Surgical Specialities, University Medical Center Utrecht, Utrecht, The Netherlands. isasim@oogh.azu.nl
de Graaf
Mieke E L
ME
Berendschot
Tos T J M
TT
Kalmann
Rachel
R
van Isterdael
Chantal
C
Mourits
Maarten P
MP
D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005094:Exophthalmos / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed