Journal article
Revision orbital decompression for thyroid eye disease
American journal of otolaryngology, Vol.43(1), pp.103196-103196
01/2022
DOI: 10.1016/j.amjoto.2021.103196
PMID: 34487995
Abstract
To compare the indications, surgical techniques and outcomes for revision orbital decompression surgery for thyroid eye disease in open, endoscopic, and combined open and endoscopic approaches.
A retrospective review of all revision orbital decompression procedures for thyroid eye disease from a single large academic institution over a 17-year period (01/01/2004–01/01/2021) was performed. Patient demographics, as well as indications and types of surgery were reviewed. Outcome measures included changes in proptosis, intraocular pressure, visual acuity and diplopia.
Thirty procedures were performed on 21 patients. There was a median of 9.4 months between primary orbital decompression and revision decompression surgery. There were 6 bilateral procedures, and 2 of these patients underwent additional revision surgeries due to decreased visual acuity with concern for persistent orbital apex compression or sight-threatening ocular surface exposure in the setting of proptosis. Twenty-five procedures were performed as open surgeries with 5 endoscopic/combined cases. Combined Ophthalmology/Otolaryngology surgery via combined open/endoscopic approaches was favoured for persistent orbital apex disease. Visual acuity remained preserved in all patients. The overall median reduction in proptosis was 2 mm and intraocular pressure change was 1 mmHg regardless of surgical approach. The overall rate of new onset diplopia after surgery was 15%. These patients had open approaches. All endoscopic/combined approach patients had pre-existing diplopia. There were no statistically significant differences between the open and endoscopic/combined groups in regard to change in visual acuity, reduction in proptosis or intraocular pressure.
Revision orbital decompression is an uncommon procedure indicated for those patients with progressive symptoms despite previous surgery and intensive medical management. Both endoscopic and non-endoscopic techniques offer favourable outcomes with respect to visual acuity, decrease in intraocular pressure, and improvement in proptosis and overall lead to a low incidence of new onset diplopia.
Level IV.
Details
- Title: Subtitle
- Revision orbital decompression for thyroid eye disease
- Creators
- Truong An Pham - University of Iowa Hospitals and ClinicsBrittany Simmons - Visual SciencesNicholas J. Potter - University of Iowa Hospitals and ClinicsZaid Al-Qurayshi - University of Iowa Hospitals and ClinicsKeith D. Carter - University of IowaScott M. Graham - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of otolaryngology, Vol.43(1), pp.103196-103196
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjoto.2021.103196
- PMID
- 34487995
- ISSN
- 0196-0709
- eISSN
- 1532-818X
- Language
- English
- Date published
- 01/2022
- Academic Unit
- Neurosurgery; Otolaryngology; Ophthalmology and Visual Sciences
- Record Identifier
- 9984303904302771
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