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Orbital Decompression for Thyroid-Related Orbitopathy During the Quiescent Phase
Lilangi S Ediriwickrema1, Bobby S Korn1,2, Don O Kikkawa1,2
1Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology, Shiley Eye Institute, La Jolla, California.
Ophthalmic Plastic and Reconstructive Surgery
|May 18, 2018
Summary
This study reviews surgical techniques for thyroid-related orbitopathy decompression. A structured, graded approach using periocular incisions effectively reduces proptosis (bulging eyes).
Area of Science:
- Ophthalmology
- Surgical Techniques
- Endocrinology
Background:
- Thyroid-related orbitopathy (TRO) can cause proptosis (bulging eyes).
- Surgical orbital decompression aims to reduce intraorbital pressure and improve ocular function.
Purpose of the Study:
- To describe historical and current surgical approaches for orbital decompression in patients with TRO in the quiescent phase.
- To propose a structured, graded surgical strategy for effective proptosis reduction.
Main Methods:
- A comprehensive literature review of published orbital decompression techniques was conducted.
- Searches were performed using the National Institutes of Health PubMed database.
Main Results:
- Historical approaches included transantral, transcranial, transnasal, and orbital routes.
- Modern techniques predominantly utilize periocular incisions for decompression and proptosis reduction.
- A proposed graded approach involves sequential fat reduction, lateral orbit decompression, medial wall decompression, posterior medial orbital floor decompression, and lateral orbital rim removal, achieving up to 10 mm proptosis reduction.
Conclusions:
- A structured, graded surgical approach to orbital decompression in TRO yields predictable and effective outcomes.
- This strategy optimizes proptosis reduction and patient results.
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