1.5 medial wall orbital decompression for sight threatening thyroid eye disease: surgical outcome and anatomical changes in orbit post-surgery
Author: Haider Zaki
Base Hospital / Institution: Royal Hallamshire Hospital
ePoster presentation
Abstract ID: 24-201
Purpose
o evaluate surgical outcomes of 1.5 medial wall decompression and observe changes in orbital anatomy after surgery
Methods
Retrospective consecutive observational study in an ophthalmic tertiary centre in the UK by reviewing patient records from 2013 to 2023.
Medial wall orbital decompression cases for sight threatening thyroid eye disease evaluated for state, severity, risk factors, activity and control of thyroid disease and thyroid related orbitopathy. Computed Tomography scan was used to study details of orbit including volume and size of extra ocular muscles before and after the decompression surgery
Results
10 patients identified in database, 8 (80%) were females and 7 (70%) had bilateral disease requiring decompression surgery to both eyes.
Most patients had fluctuating control for their thyroid disease requiring block and replace treatment with adjuvant radioiodine or thyroidectomy. Most patient were smokers and not compliant to cessation program.
Thyroid eye disease required intravenous methylprednisolone with adjuvant immunosuppression and radiotherapy together with the surgical decompression.
All patients had an average improvement of 4 Snellen chart lines in vision after the decompression surgery. Orbital changes were variable after surgery and there was reported increase in extra ocular muscle size in some cases.
Conclusion
medial 1.5 orbital decompression is a vision saving measure in severe sight threatening thyroid eye disease. Outcome depends on pre surgery medical management, control of thyroid function and adjuvant treatment.
Vision improved significantly in our cohort of patients and we observed some changes in orbit configuration post-surgery. Further research can look into the effect of using new monoclonal antibodies as adjuvants to medial decompression surgery.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Sachin | Salvi | Royal Hallamshire Hospital |
