Document Detail


Comparison of lateral and medial orbital decompression for the treatment of compressive optic neuropathy in thyroid eye disease.
MedLine Citation:
PMID:  20736873     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: : To compare the efficacy of lateral orbital decompression with medial orbital decompression for the treatment of compressive optic neuropathy (CON) caused by thyroid eye disease (TED).
METHODS: : A retrospective review of all patients undergoing orbital decompression for TED-associated CON between 2003 and 2008 was conducted. Clinical outcome measures included visual acuity, mean deviation on Humphrey visual field, Ishihara color plate testing, afferent pupillary defect, and Hertel exophthalmometry. A composite CON score was also calculated for each patient based on the 3 visual outcome measures, with a higher CON score reflecting greater disease severity.
RESULTS: : Twenty-eight eyes of 17 patients were included in the study. Ten orbits underwent lateral wall decompression, and 18 orbits underwent medial decompression. Both groups showed a significant postoperative improvement in visual acuity, Humphrey visual field testing, and color testing at 3 months following the initial surgery. The composite CON score improved 9.04 ± 9.97 points after lateral decompression (p = 0.02) and 9.03 ± 10.84 points after medial decompression (p = 0.003). There was no significant difference in the degree of improvement in any of the visual outcome measures between the lateral and medial groups. There was a statistically significant difference in the amount of proptosis reduction resulting from lateral decompression compared with medial decompression (6.3 versus 3.1 mm, respectively, p < 0.0001).
CONCLUSIONS: : Lateral orbital decompression and medial orbital decompression are both efficacious for the treatment of TED-associated CON. Lateral decompression also results in a greater proptosis reduction than medial decompression.
Authors:
Christina H Choe; Raymond I Cho; Victor M Elner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ophthalmic plastic and reconstructive surgery     Volume:  27     ISSN:  1537-2677     ISO Abbreviation:  Ophthal Plast Reconstr Surg     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508431     Medline TA:  Ophthal Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4-11     Citation Subset:  IM    
Affiliation:
Departments of *Ophthalmology and Visual Sciences and †Pathology, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, U.S.A.
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