title: [Surgical rehabilitation of patients with thyroid eye disease: systematic approach].
abstract: OBJECTIVE
  to analyze the results of surgical treatment of patients with thyroid eye disease (TED), including the type of surgery, indications, and outcomes.
  
  
  METHODS
  Hundred thirty-nine patients with TED (112 females, 27 males) aged 45.8±13.6 years.
  
  
  RESULTS
  Bony orbital decompression was performed in 91 patients (128 orbits). After the surgery, visual acuity increased from 0.84±0.47 up to 0.94±0.32 (р<0.05), exophthalmos got reduced by the average of 3.4 mm. Strabismus surgery was performed in 15 patients. The absence of diplopia in the primary position of gaze was achieved in 12 cases and the degree of residual heterophoria averaged 3.33 PD (2-6 PD). Ocular motility improved from 10.7° up to 34.58°. Eyelid surgery was performed in 81 patients.
  
  
  CONCLUSIONS
  1. Surgical treatment for thyroid eye disease is indicated in patients with visual impairment and/or significant decrease in the quality of life, if pathogenetic treatment fails. 2. The choice of surgical strategy depends on several factors, such as TED activity and severity, thyroid function, pathologic changes in the orbital tissues, and surgeon's experience and preference. 3. Current surgical techniques for thyroid eye disease enable correction of disease consequences, such as exophthalmos, optic neuropathy, impairment of ocular movement, and exposure keratopathy. 4. Adherence to the systematic approach that includes bony orbital decompression, strabismus surgery, and correction of lagophthalmos and eyelid retraction, ensures high-level functional and cosmetic rehabilitation in patients with TED.
authors.affiliation: Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, 8-2 Malaya Trubetskaya St., Moscow, Russian Federation, 119991.
authors.forename: S E
authors.initials: SE
authors.lastname: Avetisov
authors.affiliation: Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, 8-2 Malaya Trubetskaya St., Moscow, Russian Federation, 119991.
authors.forename: Ya O
authors.initials: YO
authors.lastname: Grusha
authors.affiliation: Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021.
authors.forename: D S
authors.initials: DS
authors.lastname: Ismailova
authors.affiliation: I.M. Sechenov First Moscow State Medical University, 8-2 Malaya Trubetskaya St., Moscow, Russian Federation, 119991.
authors.forename: P A
authors.initials: PA
authors.lastname: Kochetkov
authors.affiliation: Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021.
authors.forename: S S
authors.initials: SS
authors.lastname: Danilov
authors.affiliation: Endocrinology Research Center of Russian Ministry of Public Health, 11 Dmitry Ulyanov St., Moscow, Russian Federation, 117036.
authors.forename: N Yu
authors.initials: NY
authors.lastname: Sviridenko
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D049970:Graves Ophthalmopathy / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009915:Orbit / Q000000981:diagnostic imaging*; D013960:Thyroid Function Tests / Q000379:methods; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014792:Visual Acuity