Purpose

To evaluate the clinical outcomes and safety of orbital fat decompression in paediatric patients with thyroid eye disease (TED).

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Methods

This retrospective multicentre study included paediatric patients (≤17 years) with TED who underwent orbital fat decompression between June 2017 and February 2025 at two centres in Japan. Patients with follow-up of less than 3 months, prior orbital decompression, or additional eyelid surgery within 3 months were excluded. Outcomes were assessed using Hertel exophthalmometry, lower scleral show, diplopia, and postoperative complications.

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Results

Twenty patients were included. Mean proptosis significantly improved, with a reduction of 2.30 mm in the right eye (95% CI 1.77–2.83 mm; p < 0.001) and 2.39 mm in the left eye (95% CI 1.83–2.95 mm; p < 0.001). Lower scleral show improved in 84% of patients, with complete resolution in 63%. No patient developed de novo or persistent symptomatic diplopia at final follow-up. No persistent clinically significant postoperative complications were observed.

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Conclusion

Orbital fat decompression appears to be an effective and safe surgical option for selected paediatric patients with TED, providing meaningful improvement in proptosis and lower eyelid position with a low risk of clinically significant complications.

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Additional Authors

First name	Last name	Base Hospital / Institution
Tomoyuki	Kashima	Oculofacial Clinic Group

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