Development of thyroid-related orbitopathy following cataract surgery.
OBJECTIVE
To report a case series of patients who had manifestation or aggravation of thyroid related orbitopathy (TRO) following cataract surgery in an Asian eye centre.


METHODS
A systematic review of clinical records of patients with manifestation or aggravation of TRO was conducted. Inclusion criteria were manifestation or aggravation of TRO within 6 months of cataract surgery.


RESULTS
Five patients treated for TRO at Singapore National Eye Centre from January 2007 to December 2008 were included in the study. There were 2 males and 3 females with mean age of 54.6 years (range 51-86). Surgery included phacoemulsification with implantation of intraocular lens. The mean interval between surgery and manifestation of symptoms was 7.4 weeks. Contralateral eye involvement was seen in all patients. Clinical presentation of orbitopathy ranged from increased soft issue swelling, proptosis and progression of myopathy to compressive optic neuropathy. One patient had total loss of vision. Mean follow-up was 21 months (range 2-60).


CONCLUSIONS
TRO can present shortly after cataract surgery and lead to serious vision threatening complications. Patients will need to be counseled pre-operatively regarding the risk of post-operative period.
Yi
Boey Pui
BP
Singapore National Eye Centre and Singapore Eye Research Institute, Singapore 168751, Republic of Singapore. pui.yi@singhealth.com.sg
Leng
Seah Lay
SL
Kwang
Loh Boon
LB
Rootman
Jack
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D019654:Lens Implantation, Intraocular; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D018918:Phacoemulsification; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014057:Tomography, X-Ray Computed
D018828:Immunoglobulins, Thyroid-Stimulating; C094372:thyrotropin-binding inhibitory immunoglobulin; D013972:Thyrotropin; D013974:Thyroxine