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Strabismus following endoscopic orbital decompression for thyroid eye disease.
C J Roberts1, M F Murphy, G G Adams
1Moorfields Eye Hospital, London, U.K. clare_roberts@doctors.org.uk
Strabismus
|January 9, 2004
Summary
Endoscopic orbital decompression effectively reduces proptosis in thyroid eye disease. However, diplopia is a common complication, though pre-existing double vision may improve post-surgery.
Area of Science:
- Ophthalmology
- Endocrine Surgery
Background:
- Thyroid eye disease (TED) commonly causes disfiguring proptosis and sight-threatening optic nerve compression.
- Strabismus and diplopia are frequent issues in TED, often exacerbated by orbital decompression surgery.
Purpose of the Study:
- To evaluate the efficacy and complications of endoscopic orbital decompression for thyroid eye disease.
- To assess the impact of decompression on proptosis, optic nerve compression, and strabismus.
Main Methods:
- Retrospective review of 23 patients (21 female, 2 male) undergoing endoscopic orbital decompression by a single surgeon between 1994 and 2000.
- Data collected included pre- and post-operative proptosis measurements, optic nerve status, strabismus, diplopia, and best-corrected visual acuity (BSV) scores.
Main Results:
- Mean proptosis decreased by 3.3 mm after decompression.
- Seventeen patients (74%) developed manifest strabismus post-operatively, with 5 (22%) experiencing new diplopia.
- Eleven patients ultimately required strabismus surgery, with significant improvement in BSV scores post-intervention.
Conclusions:
- Endoscopic orbital decompression is an effective treatment for proptosis in thyroid eye disease.
- Diplopia is a notable complication, but pre-existing diplopia may resolve. Careful patient selection and management of strabismus are crucial.