The Effects of Bilateral Medial and Lateral Wall Orbital Decompression on Corneal Nerves, Meibomian Glands, and Dry-eye Parameters in Thyroid Eye Disease: A Corneal Confocal Microscopy Study
Author: Volkan Dericioglu
Base Hospital / Institution: Marmara University School of Medicine
ePoster presentation
Abstract ID: 24-442
Purpose
The effect of orbital decompression surgery on anterior segment structures remains unknown. This study aimed to evaluate the short- and mid-term effects of balanced orbital decompression (BOD) surgery on corneal nerves, dry eye parameters, and meibomian glands.
Methods
This prospective, interventional study included 30 orbits of 15 patients who underwent balanced orbital decompression surgery. Six orbits were excluded due to adenoviral infection during follow-up. Corneal confocal microscopy parameters—corneal nerve fiber density (CNFD), nerve branch density (CNBD), nerve fiber length (CNFL)—along with non-invasive tear break-up time (NI-BUT), meibomian gland area loss (MGAL) analysis, Schirmer test, and Oxford corneal staining score were evaluated preoperatively and at 1, 3, and 6 months postoperatively. Longitudinal analysis was conducted using the general estimating equation method with an autoregressive model and Bonferroni correction.
Results
The mean age of the patients was 42.67±12.51 years, with an equal female/male ratio. The mean preoperative Hertel measurement was 23.81±2.65 mm, which decreased to 19.54±2.84 mm in the 6th month (p<0.001). Preoperative values of CNFD, CNBD, and CNFL significantly reduced in 1st month (p<0.001 for all) and 3rd months (CNFD, p=0.010; CNBD, p=0.001; CNFL, p0.05). MGAL non-significantly decreased at 1 month (54.72±20.96 vs. 50.49±19.55, p=0.216) and significantly increased at 6 months compared to 1 month (55.64±20.06, p=0.028). NI-BUT significantly increased at 3 months (7.51±5.09 vs. 11.40±4.60 sec, p=0.010), while the Schirmer test remained unchanged (p=0.147). Corneal staining reduced at 6th month (2.16±1.13 vs. 1.33±0.96, p<0.001).
Conclusion
This is the first study investigating the effects of orbital decompression surgery on anterior segment parameters. It revealed that subbasal corneal nerve measurements returned to normal by the 6th month despite significant reductions at 1 and 3 months. NI-BUT and corneal staining improved during follow-up, while meibomian glands remained unaffected.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Burçin | Göğüş | Marmara University School of Medicine |
| Gamze | Özkan | Marmara University School of Medicine |
| Semra Akkaya | Turhan | Marmara University School of Medicine |
