title: Horizontal eye position in thyroid eye disease: a retrospective comparison with normal individuals and changes after orbital decompression surgery.
abstract: OBJECTIVE
  To compare horizontal eye positions between proptotic thyroid eye disease patients and normal individuals, and to examine positional changes after orbital decompression surgery in thyroid eye disease patients.
  
  
  METHODS
  The present case-controlled and retrospective comparative study included 78 proptotic thyroid eye disease patients who underwent bilateral orbital decompression surgery [lateral orbital wall decompression (Group L), 47 patients; medial orbital wall decompression (Group M), 9 patients; and balanced orbital decompression (Group B), 22 patients] and 143 age-matched healthy volunteers as controls. The interpupillary distance was measured to determine horizontal eye positions before and 3 months after surgery in thyroid eye disease patients and was also examined in control eyes. Horizontal eye shifts were calculated by subtracting postoperative from preoperative interpupillary distances.
  
  
  RESULTS
  Preoperative interpupillary distances in thyroid eye disease patients were significantly larger than in controls. The interpupillary distances were significantly decreased postoperatively in Groups M and B, but were significantly increased in Group L. The order of the magnitude of the horizontal shifts was Groups M>B>L.
  
  
  CONCLUSIONS
  Proptotic thyroid eye disease patients preoperatively showed laterally displaced eyes in comparison with controls. However, the eyes shifted medially after the medial orbital wall decompression and the balanced orbital decompression, although the former showed more shift. Medial orbital wall or balanced orbital decompression can be used to correct both lateral and anterior displacement of the eyes.
authors.affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kakizaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005094:Exophthalmos / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D049970:Graves Ophthalmopathy / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006972:Hypertelorism / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult