Long term results of orbital decompression in thyroid eye disease

Abstract

There are numerous reports of the short-term efficacy of orbital decompression for thyroid orbitopathy, but few studies have documented the long-term results of surgery. The authors retrospectively reviewed their long-term (mean time, 43.34 months) follow-up of 44 eyes in 23 patients who underwent orbital decompression for reduction of proptosis (Group 1: 36 eyes) or compressive optic neuropathy (Group 2: 8 eyes) at the Johns Hopkins Medical Institutions. No patient in this series experienced worsening of visual sensory function from surgery. Five of seven (71%) eyes in group 2 improved after decompression and a sixth eye recovered acuity after orbital irradiation. Postoperative worsening of ocular alignment occurred in 52% of patients and may be more likely to occur in patients who have preoperative generalized limitation of extraocular movement with or without preoperative misalignment in the primary position. Postoperative results at final examination 12 months or longer after surgery, both with respect to reduction of proptosis and improvement in visual sensory function, were either unchanged or further improved compared with findings three to six months after surgery.

Key Words:

• Thyroid disease
• orbital decompression
• strabismus
• complications
• optic neuropathy