Orbital decompression in Australia over 20 years: a retrospective population-based study
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Updated: Nov 9, 2026
Minimally Invasive Surgical Decompression of Occipital Nerves
Published on: September 13, 2024
Sachin Phakey1, Thomas G Hardy1, Alan A McNab2
1Orbital, Plastics and Lacrimal Unit, The Royal Victorian Eye and Ear Hospital, Victoria, Australia; Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia.
Objective:
To examine the frequency and cost of orbital decompression in Australia over a 20-year period and estimate the incidence of thyroid eye disease (TED) using orbital decompression data.
Design:
Retrospective population-based study.
Participants:
Individuals undergoing orbital decompression in Australia from July 2002 to June 2022, identified using the National Hospital Morbidity and Medicare databases.
Methods:
Annual orbital decompression rates (Poisson regression) were calculated, overall and by sex.
Results:
Of the 2661 orbital decompressions performed during the study period, most were for individuals aged 45-64 years (49.6%) and females (68.0%, female:male ratio 2.1:1). From 2002-2003 to 2021-2022, annual orbital decompression rates fluctuated but overall increased 1.6-fold (58.1%), from 3.7 to 5.8 surgeries per 1 000 000, respectively. Annual decompression rates stabilized during 2011-2022. During 2002-2022, annual decompression rates were greater in females than in males (mean, 7.9 vs 3.7 surgeries per 1 000 000). The estimated mean annual procedural cost associated with orbital decompression was AU$2.4 million. Over 20 years, the estimated annual incidence of TED was 7.2 per 100 000, greater in females than in males (9.8 vs 4.7 per 100 000).
Conclusions:
Orbital decompression rates increased in Australia over 20 years, stabilizing in the last decade. Decompression had a significant cost burden. These data provide a useful baseline for comparison in future studies. Decompression rates and TED incidence may vary further as novel immune-modulating therapies for Graves disease and TED, such as teprotumumab, become available in Australia.