Abstract ID: 26-525
Clinical Outcomes of Image Guided Deep Lateral Orbital Decompression with the Sonopet Ultrasonic Aspirator for Thyroid Associated Orbitopathy
Author: Ganna Zirn Base Hospital / Institution: Klinikum Stuttgart, Department of Ophthalmology, Stuttgart, Germany
Presentation Type: Video Presentation
Purpose
To evaluate proptosis reduction after image-guided deep lateral orbital decompression using the Sonopet ultrasonic aspirator in patients with thyroid-associated orbitopathy.
Methods
In this retrospective 6-month case series, 55 patients comprising 80 orbits underwent image-guided deep lateral orbital decompression with Sonopet; 25 patients (45%) had bilateral surgery. Mean age was 51.1 ± 11.9 years (range, 26-74). Proptosis reduction was assessed by Hertel exophthalmometry at 3 and 6 months. Secondary outcomes included new-onset diplopia and sensory disturbances in the zygomatic and infraorbital nerve (V2) distributions.
Results
Mean proptosis decreased from 23.5 ± 2.8 mm preoperatively to 18.5 ± 2.5 mm postoperatively. Mean reduction was 4.91 mm at 3 months (95% CI, 4.60-5.22; p < 0.001) and 4.79 mm at 6 months (95% CI, 4.47-5.10; p < 0.001). The difference between 3 and 6 months was not significant (mean difference, -0.13 mm; p = 0.183), indicating a stable effect. Higher preoperative Hertel values were associated with greater reductions at 3 months (r = 0.44; p < 0.001) and 6 months (r = 0.39; p < 0.001). Complications included new-onset diplopia in 4 patients (7%), zygomatic hypoesthesia in 17 (31%), and V2 hypoesthesia in 4 (7%); most improved during follow-up.
Conclusion
Image-guided deep lateral orbital decompression using the Sonopet ultrasonic aspirator appears effective and safe in thyroid-associated orbitopathy, achieving substantial and stable proptosis reduction at 6 months (mean, 4.8 ± 1.2 mm; range, 3.0-9.0 mm).