Orbital Decompression for Thyroid-Related Orbitopathy During the Quiescent Phase

Ophthalmic Plastic and Reconstructive Surgery
Lilangi S EdiriwickremaDon O Kikkawa

Abstract

To describe historical and modern surgical approaches to orbital decompression in patients with thyroid-related orbitopathy in the quiescent phase. A literature review of published techniques using the National Institutes of Health PubMed database. Historically, orbital decompression has been accomplished via transantral, transcranial, transnasal, and orbital approaches. Current techniques use predominately periocular incisions to achieve effective decompression and proptosis reduction. Based on exophthalmometry and desired proptosis reduction, the authors propose a graded surgical approach to decompression for thyroid orbitopathy beginning with fat reduction, followed by deep lateral orbit via a superior eyelid crease incision, then medial wall by retro-caruncular approach, then posterior medial orbital floor either via transconjunctival or swinging eyelid approach, and finally with lateral orbital rim removal by superior eyelid crease incision as needed. These approaches can result in a range of proptosis reduction of up to 10 mm. A structured approach to orbital decompression results in predictable and effective outcomes in proptosis reduction.

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Citations

Oct 24, 2019·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Yoshiyuki KitaguchiHirohiko Kakizaki
Feb 1, 2021·International Ophthalmology·Antonio Augusto V CruzRoque Lima Souza
May 29, 2020·American Journal of Ophthalmology Case Reports·Daniel J OzzelloBobby S Korn
Mar 21, 2021·International Ophthalmology Clinics·Robi N Maamari, Steven M Couch
Jun 2, 2021·Orbit·Daniel J OzzelloCatherine Y Liu
Dec 2, 2021·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Bahram EshraghiMohsen Rafizadeh

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