Periorbital Cooling therapy to improve recovery after Orbital Decompression Surgery – Randomised Control Trial
Author: Mohsan Malik
Base Hospital / Institution: Moorfields Eye Hospital
ePoster presentation
Abstract ID: 24-378
Purpose
Cooling therapy, applied during acute trauma, constricts blood vessels to lessen bleeding, bruising, and metabolic activity. It mitigates hypoxia and ischemia, thereby reducing the inflammatory response that results in swelling and pain. It’s widely endorsed post-facial surgery. However, no scientific study has proven its value in orbital surgery. We aim to investigate the effectiveness of controlled cooling therapy for patients undergoing orbital decompression surgery.
Methods
We conducted a prospective randomized study. Patient undergoing symmetrical orbital surgery were randomised to have one side of their face cooled (to 15 degrees) for five days following surgery, while we used the contra-lateral side as an auto-control using a specialised cooling mask. A visual analogue scale (0-10) evaluated patient pain scores over the first week. We also asked patients a satisfaction question regarding their experience with the machine. VECTRA 3D morphometric analysis was done to assess the volume difference between sides post-op day 1 and day 7 follow-up. Proptosis reduction was measured 1 week following the surgery.
Results
The study included 20 patients with thyroid eye disease, 16 of whom were female (80%), with an average age of 46 (range 20 – 71). Significant differences emerged in pain scores on Days 1-3 (p<0.05) with 2.5 point reduction in pain score (1-5), indicating a positive treatment effect. We observed no significant difference in pain scores from Day 4-7. No difference was found between proptosis reduction between the cooled and control sides. We found reduced gross swelling post-op on 3D morphometric analysis, between cooled and uncooled device.
Eight participants (40%) reported noticeable difference in reduced swelling in the cooled side. Participants rated the device 2.9 out of 5 for comfort and 4.05 out of 5 for ease of use.
Conclusion
Our data support cooling therapy during the first three days to reduce post-operative discomfort following orbital decompression surgery, with the most significant effect size noted on day 1) and reduced post-operative swelling.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Hannah | Timlin | Moorfields Eye Hospital |
| Daniel | Ezra | Moorfields Eye Hospital |
| Jimmy | Uddin | Moorfields Eye Hospital |
| Geoffery | Rose | Moorfields Eye Hospital |
| David | Verity | Moorfields Eye Hospital |
