title: Lower incidence of chemosis with the Berke incision approach versus the swinging eyelid approach after deep lateral orbital wall decompression.
abstract: OBJECTIVE
  To compare the incidence of chemosis following deep lateral orbital wall decompression using the Berke incision approach vs the swinging eyelid approach.
  
  
  METHODS
  This study retrospectively reviewed 49 sides in 29 patients who underwent decompression via the Berke incision approach (Group A) and 122 sides in 71 patients who underwent decompression via the swinging eyelid approach (Group B).
  
  
  RESULTS
  The incidence of chemosis was significantly lower in Group A (30.6%) compared with Group B (48.4%; p = 0.034). Although the period until subsidence of chemosis did not differ between the groups (p = 0.164), the ratio of sides that needed intensive postoperative care was lower in Group A than in Group B (p = 0.002). Chemosis tended to occur more frequently in sides with a history of steroid administration relative to those without previous steroid administration (Group A, p = 0.042; Group B, p = 0.059), although past radiation therapy and past combined radiation and steroid therapy did not influence the occurrence of chemosis (p > 0.050). Postoperative proptosis reduction was similar in both groups (p = 0.087).
  
  
  CONCLUSIONS
  It was found that the Berke incision approach yielded a lower incidence of chemosis while achieving similar postoperative proptosis reduction in comparison with the swinging eyelid approach. These findings suggest that the Berke incision approach is an acceptable alternative procedure for deep lateral orbital wall decompression.
authors.affiliation: a 1 Department of Ophthalmology, Aichi Medical University , Nagakute, Aichi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: a 1 Department of Ophthalmology, Aichi Medical University , Nagakute, Aichi, Japan.|b 2 Department of Ophthalmology, University of Seonam College of Medicine, Presbyterian Medical Center , Jeonju, Korea.
authors.forename: Hyera
authors.initials: H
authors.lastname: Kang
authors.affiliation: a 1 Department of Ophthalmology, Aichi Medical University , Nagakute, Aichi, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kakizaki
mesh_terms: D000293:Adolescent; D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D004487:Edema / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: Berke incision approach; Chemosis; deep lateral orbital wall decompression; swinging eyelid approach