title: Results of diplopia and strabismus in patients with severe thyroid ophthalmopathy after orbital decompression.
abstract: OBJECTIVE
  It has been frequently stated that the orbital decompression, in patients with thyroid ophthalmopathy, does not usually improve extraocular muscles function and that after the operation there is often a deterioration of these functions. The purpose of this article is evaluation of extraocular muscles function after applying personal method of 3 wall orbital decompression.
  
  
  METHODS
  Retrospective review of case records of 119 patients with severe thyroid ophthalmopathy seen and treated by the author between December 1986 and December 2010. All patents underwent 3 wall orbital decompression combined with removal of the periorbital, intraorbital and retrobulbar fat. Correction of coexistent eyelid retraction and deformities were also performed.
  
  
  RESULTS
  Comparison of preoperative and postoperative results was conducted in 65 patients three months after 3 wall decompression. All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms. There were no cases of subsequent impairment of ocular motility. Strabismus surgery was performed in 6 patients with residual diplopia. There was an improvement in vision in 68% patients who had impaired vision before the operation. Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.
  
  
  CONCLUSIONS
  It can be concluded that this method of orbital decompression is logical, based on an understanding of the pathology, has less complication rates, is relatively easy to perform, gives very good functional and aesthetic long term results and allows rapid recovery.
authors.affiliation: Department of Ophthalmology, Revida Hospital, Belgrade, Serbia.
authors.forename: Radmilo
authors.initials: R
authors.lastname: Roncevic
authors.forename: Zorica
authors.initials: Z
authors.lastname: Savkovic
authors.forename: Dusan
authors.initials: D
authors.lastname: Roncevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D004172:Diplopia / Q000209:etiology / Q000503:physiopathology*; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D009915:Orbit / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D055815:Young Adult