The effect of anterior orbital decompression on motility in thyroid exophthalmos

Nineteen orbits from 13 patients with endocrine exophthalmos were effectively decompressed into the maxillary and ethmoid antra through an anterior orbitotomy. Six patients with preoperative diplopia had improved ocular ductions and return of binocular single vision in functional positions. Diplopia was not induced in five patients with normal pre-op motility. In one patient with active orbitopathy, a large postoperative esotropia was caused by worsening of medial rectus inflammation. This approach appears to lessen the incidence of postoperative diplopia and may make subsequent extraocular muscle procedures unnecessary.