The Effect of Orbital Decompression on diplopia and Strabismus in Patients with Graves’ Orbitopathy
Author: Jeong Kyu Lee
Base Hospital / Institution: Chung-Ang University Hospital
ePoster presentation
Abstract ID: 25-283
Purpose
This study aimed to investigate the surgical outcomes of orbital decompression and its impact on ocular motility and strabismus in patients diagnosed with Graves’ orbitopathy (GO).
Methods
A retrospective analysis was conducted on the medical records of patients diagnosed with GO who underwent orbital decompression. Patients were categorized into groups based on the surgical technique utilized: medial wall decompression, medial and inferior wall decompression, balanced decompression, and three-wall decompression. The degree of proptosis, strabismus, and diplopia were evaluated preoperatively and at one week, three months, six months, or later postoperatively.
Results
Among the 557 patients analyzed, 444 underwent bilateral orbital decompression, while 113 underwent unilateral procedures. The group for medial wall decompression comprised 154 patients (27.6%), the medial and inferior wall decompression group included 65 patients (11.7%), the balanced decompression group consisted of 203 patients (36.4%), and the three-wall decompression group encompassed 135 patients (24.2%). Of the 442 patients who did not present with ocular motility disorders or diplopia prior to surgery, 23 patients (5.7%) developed diplopia during primary gaze postoperatively; among these, 14 had undergone balanced decompression, 3 had three-wall decompression, and 3 had medial and inferior wall decompression. Additionally, of the 65 patients with preoperative ocular motility disorders but without diplopia, 10 patients (15.4%) experienced diplopia during primary gaze following surgery. Notably, patients with preoperative esotropia demonstrated a significant increase in the angle of esotropia.
Conclusion
It is essential to carefully consider surgical techniques, especially for patients presenting with preoperative ocular motility disorders or esotropia, as there is a risk of exacerbating diplopia and strabismus.
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