Abstract ID: 26-204
Microscopic Deep Orbital Fat Decompression Combined with Autologous Resected Fat Grafting to the Cheek for Thyroid Eye Disease
Author: Tomoyuki Kashima Base Hospital / Institution: Oculofacial Clinic Group
Presentation Type: Oral Presentation Session: OrbitDate: 11th SeptemberTime: 15.00PM
Purpose
Thyroid eye disease (TED) often causes exophthalmos, lower eyelid retraction, and prominent infraorbital dark circles, leading to significant facial disfigurement. While orbital decompression addresses protrusion, infraorbital aesthetic concerns are frequently overlooked. This study evaluates the outcomes of a single-stage surgical procedure combining microscopic deep orbital fat decompression with autologous grafting of the resected fat into the cheek area to address both functional and aesthetic deformities.
Methods
A retrospective comparative study was conducted on 72 patients with TED who underwent microscopic orbital fat decompression. In all cases, a surgical microscope was utilized for retrobulbar fat resection. Patients were divided into two groups: Group A (n=35) received orbital lipectomy alone, and Group B (n=37) received orbital lipectomy combined with autologous fat grafting (0.5 mL of resected fat transplanted into the supraperiosteal plane after orbicularis retaining ligament release). Four independent blinded observers scored the severity of dark circles using the Dark Circle Severity Classification (DCSC) on a 4-point scale (0–3).
Results
The mean volume of resected orbital fat was 3.3±1.3 mL, resulting in a mean proptosis reduction of 2.1 mm. No vision-threatening complications or new-onset diplopia occurred. In Group A, the mean DCSC score improved from 1.69±0.79 to 0.55±0.59 (P < 0.0001). In Group B, the score improved from 2.26±0.73 to 0.26±0.50 (P < 0.0001). Postoperative DCSC scores and the degree of improvement were significantly superior in Group B compared to Group A (P < 0.0001).
Conclusion
Combining microscopic deep orbital fat decompression with autologous fat grafting is a safe and effective technique for TED patients. This approach simultaneously addresses exophthalmos and infraorbital dark circles in a single surgical setting, providing superior aesthetic and functional outcomes with a low complication rate.