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Intersurgeon Variability in Proptosis Reduction After Orbital Decompression for Thyroid Eye Disease: A Multicenter
Ashley Hong1,2,3, Marissa K Shoji1,2, George A Villatoro2
1Division of Oculofacial Plastic and Reconstructive Surgery, University of California San Diego, La Jolla, California, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|October 13, 2025
Summary
Surgeons show similar results in reducing proptosis for thyroid eye disease patients using identical orbital decompression methods. This finding supports consistent outcomes in multicenter trials for thyroid eye disease management.
Area of Science:
- Ophthalmology
- Surgical Research
- Endocrinology
Background:
- Thyroid eye disease (TED) can cause proptosis, impacting quality of life.
- Orbital decompression surgery aims to reduce proptosis.
- Understanding intersurgeon variability is crucial for standardizing outcomes.
Purpose of the Study:
- To assess intersurgeon variability in proptosis reduction after orbital decompression for thyroid eye disease.
- To compare outcomes among surgeons using similar orbital decompression techniques.
Main Methods:
- Multicenter retrospective study (2002-2018) of patients with thyroid eye disease undergoing orbital decompression.
- Included data from 7 surgeons at 7 institutions.
- Analyzed 5 decompression techniques, focusing on surgeons performing ≥10 cases per technique.
Main Results:
- 633 orbits analyzed across 5 decompression techniques.
- No significant difference in proptosis reduction among surgeons using similar techniques.
- Preoperative proptosis was significantly associated with postoperative change (p < 0.001).
Conclusions:
- Surgeons exhibit comparable proptosis reduction outcomes when employing uniform orbital decompression techniques for thyroid eye disease.
- Findings support the statistical validity of multicenter trials using standardized surgical approaches.
- Enhances understanding of optimal surgical management for thyroid eye disease.
