title: Intraocular pressure change with eye positions before and after orbital decompression for thyroid eye disease.
abstract: OBJECTIVE
  To examine intraocular pressure (IOP) changes in primary and upward gazes before and after orbital decompression in patients with thyroid eye disease.
  
  
  METHODS
  Seventy-eight orbits of 40 patients who underwent orbital decompression between June 2010 and September 2012 were retrospectively reviewed. Subjects were divided in 2 groups according to the number of orbital walls removed: deep lateral orbital wall decompression group (Group A) or balanced decompression group (Group B). IOP was measured using Goldmann applanation tonometry in primary gaze and a 20° upward gaze before and 3 months after surgery.
  
  
  RESULTS
  Preoperative IOP in upward gaze (18.7 mm Hg) was higher than in primary gaze (15.7 mm Hg, p < 0.001). Postoperative IOP reduction in upward gaze (3.8 mm Hg) was greater than in primary gaze (1.7 mm Hg, p < 0.001). Although the overall postoperative IOP in upward gaze (14.9 mm Hg) remained higher than in primary gaze (14.0 mm Hg, p = 0.038), the gaze-related IOP demonstrated no significant difference in all subgroups (Group A, p = 0.091; Group B, p = 0.332).
  
  
  CONCLUSIONS
  IOP in upward gaze was higher prior to orbital decompression, but reduction was greater postoperatively and approximated the IOP in primary gaze.
authors.affiliation: *Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi; and †Department of Plastic Surgery, Kobe University School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ichinose
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kakizaki
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D049970:Graves Ophthalmopathy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D009916:Orbital Diseases / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D055815:Young Adult