Surgical complications in orbital decompression for Graves' orbitopathy

Area of Science:

• Ophthalmology
• Neurosurgery
• Endocrinology

Background:

• Graves' orbitopathy is an autoimmune condition affecting the eye socket.
• Orbital decompression surgery is a common treatment for severe cases.

Purpose of the Study:

• To analyze the complications associated with orbital decompression in Graves' orbitopathy.
• To compare complication rates across different surgical approaches.

Main Methods:

• Retrospective review of 946 patient records undergoing orbital decompression.
• Analysis of intra- and post-operative complications with a minimum six-month follow-up.
• Literature review to compare findings with existing studies.

Main Results:

• Temporal wasting (100%) with coronal approach; V2 hypoesthesia (13%) with upper eyelid incision.
• Severe complications included visual acuity reduction (5 patients) and CSF leak (2 patients) with non-endoscopic endonasal approach.
• Endoscopic endonasal and transpalpebral approaches showed a low incidence of complications (e.g., symptomatic sinusitis/mucoceles 0.75%).

Conclusions:

• Orbital decompression via endoscopic endonasal and transpalpebral techniques is associated with a low complication rate.
• Understanding approach-specific complications can minimize their occurrence.
• This knowledge aids in improving patient outcomes for Graves' orbitopathy.