Inferior orbital decompression for dysthyroid optic neuropathy

Area of Science:

• Ophthalmology
• Neurosurgery
• Endocrinology

Background:

• Dysthyroid optic neuropathy (DON) is a vision-threatening complication of Graves' disease.
• Inferior orbital decompression is a surgical option for managing DON.
• The lower-lid approach offers access to the orbital floor and maxillary sinus.

Purpose of the Study:

• To evaluate the efficacy of inferior orbital decompression via a lower-lid approach in patients with dysthyroid optic neuropathy.
• To assess the impact of the surgical technique on visual function.

Main Methods:

• Retrospective case series of eight patients (six bilateral, two unilateral) with DON.
• Surgical intervention involved inferior orbital decompression through an inferolateral approach.
• Procedure included removal of the orbital floor and ethmoidal and maxillary antral mucosa.

Main Results:

• All patients demonstrated improvement in visual function post-surgery.
• Improvements were noted in visual acuity, visual fields, and visually evoked potentials.
• No significant intraoperative or postoperative complications were reported.

Conclusions:

• Inferior orbital decompression through a lower-lid approach is an effective surgical treatment for dysthyroid optic neuropathy.
• This technique successfully restores visual function by decompressing the optic nerve.
• The lower-lid approach provides safe and adequate access for orbital floor decompression.