title: Treatment of exophthalmos and strabismus surgery in thyroid-associated orbitopathy.
abstract: Endocrine orbitopathy (EO) can have important consequences, such as exophthalmos and restrictive strabismus. A retrospective study was performed of 35 patients with EO who underwent orbital decompression surgery and restrictive strabismus correction. Two surgical techniques for orbital decompression were analyzed: fat decompression by Olivari technique and three-wall bony expansion with fat decompression. Strabismus surgery was performed using adjustable or non-adjustable sutures under topical anaesthesia. Patients were divided into two groups according to the type of intra-orbital decompression performed, and the postoperative values resulting from the different fat decompression techniques were recorded. The preoperative and postoperative mean degrees of exophthalmos were 22.3 and 19.9mm, respectively, for the fat decompression group, and 24.3 and 19.8mm, respectively, for the bony expansion with transpalpebral fat decompression (combined form) group. The difference in residual prism dioptres between adjustable and non-adjustable suture techniques in patients who had previously undergone combined decompression was statistically significant. The management of patients with EO requires a multidisciplinary approach based on the collaboration of maxillofacial surgeons, ophthalmologists, and orthoptists. These results will allow the development of a more adequate strategy for the surgical treatment of restrictive strabismus in EO patients.
authors.affiliation: Clinic of Ophthalmology, St. Anna Hospital and University, Ferrara, Cona, Italy. Electronic address: aurelioimburgia@yahoo.it.
authors.forename: A
authors.initials: A
authors.lastname: Imburgia
authors.affiliation: Unit of Cranio-Orbito-Maxillofacial Surgery, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Elia
authors.affiliation: Clinic of Ophthalmology, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Franco
authors.affiliation: Clinic of Ophthalmology, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Perri
authors.affiliation: Clinic of Ophthalmology, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Franco
authors.affiliation: Unit of Cranio-Orbito-Maxillofacial Surgery, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Galiè
authors.affiliation: Unit of Cranio-Orbito-Maxillofacial Surgery, St. Anna Hospital and University, Ferrara, Cona, Italy.
authors.forename: L C
authors.initials: LC
authors.lastname: Clauser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005094:Exophthalmos / Q000209:etiology / Q000601:surgery*; D005260:Female; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D012189:Retrospective Studies; D013285:Strabismus / Q000209:etiology / Q000601:surgery*; D013536:Suture Techniques
keywords: adjustable sutures; endocrine orbitopathy; orbital decompression; restrictive strabismus; strabismus surgery; thyroid associated ophthalmopathy