title: [Reoperation after orbital decompression for Graves' ophthalmopathy].
abstract: BACKGROUND
  The aim of our study was to report the incidence of complications requiring early or late reoperation after bone and fat orbital decompression for Graves's ophthalmopathy.
  
  
  METHODS
  We conducted a retrospective bicentric study in the Maxillofacial Surgery Departments of Marseille and Lyon. Ninety patients were selected from 2006 to 2010, accounting for 168 orbital decompressions. The surgical indication was morphological and functional for all patients. Several surgical techniques were used: bone and fat orbital decompression by trans-palpebral resection, two or three wall orbital decompression, malar valgization.
  
  
  RESULTS
  Ten patients were reoperated for 12 revisions, two patients needed two revisions. There were four early revisions for two retro-orbital hematoma, one inadequate orbital decompression with persistent posterior compressive optic neuropathy, and one recurrent maxillary sinusitis with proptosis. The other eight revisions were carried out later for three cases of insufficient correction, four cases of proptosis relapse, and one for excessive correction with enophthalmos. All patients had satisfactory morphological and functional results despite revision surgery.
  
  
  CONCLUSIONS
  Most reoperations are difficult to anticipate and their prevention is based on more or less specific recommendations. Patients should be informed of the risks and benefits and accept the possibility of reoperation. A systematic multidisciplinary consultation would standardize and improve the management of these patients, by detecting patients at risk of complications and thus reoperation.
authors.affiliation: Service de chirurgie maxillo-faciale et plastique de la face, hôpital Nord, chemin des Bourrely, Marseille, France. nathalie.dumont08@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Dumont
authors.forename: P
authors.initials: P
authors.lastname: Bouletreau
authors.forename: L
authors.initials: L
authors.lastname: Guyot
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D015841:Enophthalmos / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000453:epidemiology / Q000601:surgery*; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D009915:Orbit / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult