Surgical Outcomes of Balanced Deep Lateral and Medial Orbital Wall Decompression in Korean Population: Clinical and Computed Tomography-based Analysis
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Purpose: To evaluate the clinical outcomes of balanced deep lateral and medial orbital wall decompression andto estimate surgical effects using computed tomography (CT) images in Korean patients with thyroid-associatedophthalmopathy (TAO). Methods: Retrospective chart review was conducted in TAO patients with exophthalmos who underwent balanceddeep lateral and medial orbital wall decompression. Exophthalmos was measured preoperatively andpostoperatively at 1 and 3 months. Postoperative complications were evaluated in all study periods. In addition,decompressed bone volume was estimated using CT images. Thereafter, decompression volume in eachdecompressed orbital wall was analyzed to evaluate the surgical effect and predictability. Results: Twenty-four patients (48 orbits) with an average age of 34.08 ± 7.03 years were evaluated. The meanpreoperative and postoperative exophthalmos at 1 and 3 months was 18.91 ± 1.43, 15.10 ± 1.53, and 14.91 ± 1.49mm, respectively. Bony decompression volume was 0.80 ± 0.29 cm3 at the medial wall and 0.68 ± 0.23 cm3 atthe deep lateral wall. Postoperative complications included strabismus (one patient, 2.08%), upper eyelid foldchange (four patients, 8.33%), and dysesthesia (four patients, 8.33%). Postsurgical exophthalmos reductionwas more highly correlated with the deep lateral wall than the medial wall. Conclusions: In TAO patients with exophthalmos, balanced deep lateral and medial orbital wall decompressionis a good surgical method with a low-risk of complications. In addition, deep lateral wall decompression hashigher surgical predictability than medial wall decompression, as seen with CT analysis.
Abstract
Purpose: To evaluate the clinical outcomes of balanced deep lateral and medial orbital wall decompression andto estimate surgical effects using computed tomography (CT) images in Korean patients with thyroid-associatedophthalmopathy (TAO). Methods: Retrospective chart review was conducted in TAO patients with exophthalmos who underwent balanceddeep lateral and medial orbital wall decompression. Exophthalmos was measured preoperatively andpostoperatively at 1 and 3 months. Postoperative complications were evaluated in all study periods. In addition,decompressed bone volume was estimated using CT images. Thereafter, decompression volume in eachdecompressed orbital wall was analyzed to evaluate the surgical effect and predictability. Results: Twenty-four patients (48 orbits) with an average age of 34.08 ± 7.03 years were evaluated. The meanpreoperative and postoperative exophthalmos at 1 and 3 months was 18.91 ± 1.43, 15.10 ± 1.53, and 14.91 ± 1.49mm, respectively. Bony decompression volume was 0.80 ± 0.29 cm3 at the medial wall and 0.68 ± 0.23 cm3 atthe deep lateral wall. Postoperative complications included strabismus (one patient, 2.08%), upper eyelid foldchange (four patients, 8.33%), and dysesthesia (four patients, 8.33%). Postsurgical exophthalmos reductionwas more highly correlated with the deep lateral wall than the medial wall. Conclusions: In TAO patients with exophthalmos, balanced deep lateral and medial orbital wall decompressionis a good surgical method with a low-risk of complications. In addition, deep lateral wall decompression hashigher surgical predictability than medial wall decompression, as seen with CT analysis.
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