Aesthetic Deep Orbital Fat Decompression for Proptosis of Nonthyroidal Origin: A Case Series of 23 Patients

This study sought to assess the safety, efficacy, and cosmetic outcomes of aesthetic deep orbital fat decompression for nonthyroidal proptosis.

A retrospective review was conducted on 23 patients who underwent bilateral aesthetic deep orbital fat decompression at the Oculofacial Clinic Tokyo between 2022 and 2024. Preoperative and postoperative assessments included Hertel measurements, interpupillary distance, intraocular pressure, best corrected visual acuity, and fusion image area. Procedures were performed by senior attending surgeons, with outpatient follow-up conducted by attending physicians and clinical fellows.

The mean volume of resected fat was 3.0 ± 1.0 mL. Hertel measurements significantly decreased from 19.0 ± 2.7 to 16.7 ± 2.8 mm (P < 0.001), interpupillary distance narrowed from 66.2 ± 3.5 to 63.9 ± 3.1 mm (P < 0.001), and intraocular pressure reduced from 16.2 ± 2.9 to 14.0 ± 2.4 mm Hg (P < 0.001). Best corrected visual acuity and fusion image area remained stable. No permanent visual loss or diplopia was observed during the follow-up period. Minor complications, including transient diplopia and mild ocular discomfort, resolved spontaneously without the need for intervention.

Aesthetic deep orbital fat decompression appeared to be a safe and effective procedure for congenital proptosis, achieving significant cosmetic and functional improvements. However, future prospective investigations are warranted to establish its long-term safety and efficacy.