title: Orbital fat decompression for thyroid eye disease: retrospective case review and criteria for optimal case selection.
abstract: OBJECTIVE
  The purpose of this study is to identify the subgroups of thyroid eye disease (TED) patients most likely to benefit from orbital fat decompression.
  
  
  METHODS
  This retrospective study reviews 217 orbits of 109 patients who underwent orbital fat decompression for proptosis secondary to thyroid eye disease. Charts were reviewed for demographic, radiographic, clinical, and surgical data. Three groups of patients were defined for the purposes of statistical analysis: those with proptosis secondary to expansion of the fat compartment (group I), those with proptosis secondary to enlargement of the extraocular muscles (group II), and those with proptosis secondary to enlargement of both fat and muscle (group III).
  
  
  RESULTS
  Groups I and II, and those patients with greater preoperative proptosis and those with a history of radiation therapy were most likely to benefit from orbital fat decompression. However, even those in group III or with lesser proptosis appreciated significant benefit.
  
  
  CONCLUSIONS
  While orbital fat decompression can and, at times, should be combined with bone decompression to treat proptosis resulting from thyroid eye disease, orbital fat decompression alone is associated with lower rates of surgical morbidity, and is especially effective for group I and II patients, those with greater preoperative proptosis, and those with a history of radiation.
authors.affiliation: *Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York, U.S.A.; and †Oculoplastics and Orbital Surgery Service, Department of Ophthalmology, Hospital del Mar-Esperanza, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Marta Calsina
authors.initials: MC
authors.lastname: Prat
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Braunstein
authors.forename: Lora R
authors.initials: LR
authors.lastname: Dagi Glass
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005094:Exophthalmos / Q000209:etiology / Q000601:surgery*; D005260:Female; D049970:Graves Ophthalmopathy / Q000150:complications / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology; D009915:Orbit / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed