Purpose

To evaluate the effects of orbital fat decompression on proptosis, lower eyelid position, ocular surface status, and postoperative complications in inactive thyroid eye disease (TED).

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Methods

A retrospective study was performed in 9 patients (18 eyes) with inactive TED who underwent bilateral orbital fat decompression. Clinical evaluations before and approximately 3 months after surgery included Hertel exophthalmometer measurements, margin reflex distance-1 (MRD-1), MRD-2, palpebral fissure height, lagophthalmos, and ocular surface scores. Keratoconjunctival staining examination was graded on a 9-point scale. Postoperative complications were assessed.

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Results

The study included 1 man and 8 women with a mean age of 45.8 years. Mean disease duration was 41.8 months. Hertel exophthalmometer measurements improved from 21.5 mm to 18.9 mm, with a mean reduction of 2.63 mm. MRD-1 remained unchanged, whereas MRD-2 decreased from 7.2 mm to 5.5 mm. Palpebral fissure height decreased from 11.3 mm to 9.6 mm. Both patients with preoperative lagophthalmos showed postoperative improvement. Mean keratoconjunctival staining score improved from 1.36 to 1.00. No patients developed new-onset or worsening diplopia. Transient eyelid ecchymosis occurred in all patients and transient mydriasis in 2 patients.

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Conclusion

Orbital fat decompression effectively reduced proptosis without inducing diplopia in inactive TED. The procedure also improved lower eyelid position, lagophthalmos, and ocular surface status, suggesting that orbital fat decompression may contribute to both cosmetic and ocular surface improvement in inactive TED.

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Additional Authors

First name	Last name	Base Hospital / Institution
Masashi	Mimura	Ehime University Hospital
Daisuke	Kiyooka	Ehime University Hospital
Hirohito	Iimori	Ehime University Hospital
Arisa	Mitani	Ehime University Hospital
Atsushi	Shiraishi	Ehime University Hospital

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