Transconjunctival fat removal combined with conservative medial wall/floor orbital decompression for Graves orbitopathy.
OBJECTIVE
To evaluate the utility of transconjunctival fat removal combined with conservative ("strut-sparing") bony medial/floor orbital decompression for Graves orbitopathy.


METHODS
Retrospective, noncomparative case series of 52 orbits in 28 patients that underwent decompression using this technique. Preoperative and postoperative exophthalmos, diplopia, logMAR visual acuity, and orbital symmetry were measured.


RESULTS
Reduction in exophthalmos up to 8 mm with a mean of 3.3 mm (+/-1.5 mm) was achieved for decompressed orbits (p < 0.001). Postoperative symmetry within 2 mm was achieved in all patients. Diplopia was improved in 4 patients (14%), unchanged in 23 (82%), and worse in 1 (4%). Mean logMAR visual acuity improved -0.11 units (p = 0.007).


CONCLUSIONS
Orbital fat removal combined with conservative ("strut-sparing") bony medial/floor orbital decompression via a single transconjunctival incision is an effective and efficient technique with minimal morbidity.
O'Malley
Martin R
MR
Ophthalmic Plastic Surgery, Lions Eye Institute, Albany Medical Center, Albany, New York 12159, USA. momalley2@aol.com
Meyer
Dale R
DR
D000273:Adipose Tissue / Q000601:surgery*; D003228:Conjunctiva / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D049970:Graves Ophthalmopathy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome