title: Surgical Outcomes of Balanced Deep Lateral and Medial Orbital Wall Decompression in Korean Population: Clinical and Computed Tomography-based Analysis.
abstract: OBJECTIVE
  To evaluate the clinical outcomes of balanced deep lateral and medial orbital wall decompression and to estimate surgical effects using computed tomography (CT) images in Korean patients with thyroid-associated ophthalmopathy (TAO).
  
  
  METHODS
  Retrospective chart review was conducted in TAO patients with exophthalmos who underwent balanced deep lateral and medial orbital wall decompression. Exophthalmos was measured preoperatively and postoperatively at 1 and 3 months. Postoperative complications were evaluated in all study periods. In addition, decompressed bone volume was estimated using CT images. Thereafter, decompression volume in each decompressed orbital wall was analyzed to evaluate the surgical effect and predictability.
  
  
  RESULTS
  Twenty-four patients (48 orbits) with an average age of 34.08 ± 7.03 years were evaluated. The mean preoperative and postoperative exophthalmos at 1 and 3 months was 18.91 ± 1.43, 15.10 ± 1.53, and 14.91 ± 1.49 mm, respectively. Bony decompression volume was 0.80 ± 0.29 cm(3) at the medial wall and 0.68 ± 0.23 cm(3) at the deep lateral wall. Postoperative complications included strabismus (one patient, 2.08%), upper eyelid fold change (four patients, 8.33%), and dysesthesia (four patients, 8.33%). Postsurgical exophthalmos reduction was more highly correlated with the deep lateral wall than the medial wall.
  
  
  CONCLUSIONS
  In TAO patients with exophthalmos, balanced deep lateral and medial orbital wall decompression is a good surgical method with a low-risk of complications. In addition, deep lateral wall decompression has higher surgical predictability than medial wall decompression, as seen with CT analysis.
authors.affiliation: Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Sang Uk
authors.initials: SU
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Woo
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jeong Kyu
authors.initials: JK
authors.lastname: Lee
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D005094:Exophthalmos / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D049970:Graves Ophthalmopathy / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D056910:Republic of Korea; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Exophthalmos reduction; Graves ophthalmopathy; Orbital decompression