Cosmetic orbital inferomedial decompression: quantifying the risk of diplopia associated with extraocular muscle dimensions

Ophthalmic Plastic and Reconstructive Surgery
Felipe EingAntonio Augusto Velasco e Cruz

Abstract

To quantify the risk of new diplopia in inferomedial orbital decompression performed for cosmetic reasons. Retrospective analysis of 114 patients with Graves orbitopathy who underwent an inferomedial orbital decompression. No patient had diplopia in any of the gaze positions or optic neuropathy. A single coronal slice 9 mm posterior to the lateral orbital rim was employed to quantify the muscular index of the extraocular recti and of the superior complex. A control group of 56 patients imaged for other reasons were also measured. After surgery the oculomotor status of all patients who complained of diplopia and of 51 patients free of diplopia was measured with the prism and cover test in the primary and secondary gaze positions. The rate of new-onset diplopia was 14.0% (16 patients). Eye deviations were confirmed in 14 patients. Of these, 10 had significant strabismus that warranted surgical or prism treatment. Most patients had esotropia associated with small vertical deviations. The size of the medial and inferior recti was significantly associated with the development of diplopia. The estimated odds for the appearance of diplopia in patients with muscle enlargement was 12.76 (medial rectus) and 5.21 (inferior rectus). Small-...Continue Reading

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Citations

Nov 19, 2013·Journal français d'ophtalmologie·B LerayP Caron
Mar 8, 2014·International Ophthalmology·Julio González-Martín-MoroRoberto García-Leal
Aug 2, 2019·The Journal of Craniofacial Surgery·Jong Woo Kim, Sung Mo Kang
Jun 25, 2021·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Patricia Ann L LeeYasuhiro Takahashi

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