[Outcomes of modified lateral orbital wall decompression using ultrasonic bone removal]

This study presents a comparative analysis of outcomes of lateral orbital wall decompression performed using ultrasonic bone removal with standard and modified techniques.

The study included 78 patients (109 orbits) with exophthalmos without visual impairment (subgroups 1A and 1B) and with optic neuropathy (ON) due to thyroid eye disease (TED) (subgroups 2A and 2B). Lateral wall decompression (LWD) was performed using ultrasonic bone removal with a modified (n=58, patient subgroups 1A and 2A) or standard (n=51, subgroups 1B and 2B) technique. Postoperative evaluation included visual function, degree of exophthalmos, and palpebral fissure parameters.

In subgroup 1A, exophthalmos regression averaged 3.8±0.9 mm, while in subgroup 1B it amounted to 2.9±0.8 mm. Comparable improvement in visual acuity was observed in subgroups 2A and 2B, with a median gain of 0.4, along with positive changes in perimetry and color vision.

The modified LWD technique using ultrasonic bone removal achieved a mean exophthalmos reduction of approximately 4 mm. In cases complicated by ON, improvement in visual function was observed for up to 4 years.