Document Detail


Surgical treatment of severe dysthyroid ophthalmopathy--long-term results.
MedLine Citation:
PMID:  8839329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Conservative therapy in cases of severe dysthyroid ophthalmopathy (DO) has not given satisfactory results. Since 1986, 51 patients (99 orbits) with marked DO have been treated by surgical decompression of the orbits. The procedure begins within the upper eyelid. The excision of the excessive skin and subcutaneous tissue is performed and eyelid fat is removed. In order to obtain the correction of the upper eyelid retraction, the levator aponeurosis is divided by 2-3 transverse incisions in its central part and Muller's muscle is sectioned at the level of its tarsal insertion. Through an incision in the lower eyelid, the posterior part of the orbital floor, the lateral orbit wall, as well as the periorbital and intraorbital fat are removed. Through an incision made over the medial margin of the orbit, the ethmoidal part of the medial orbital wall and the retrobulbar fat are removed. The periorbital periosteum should be incised at several sites. After operation all patients showed a significant reduction of exophthalmos (5-11 mm, 7.16 mm on average), significant reduction of intraocular pressure, marked improvement in ocular muscle function, as well as considerable reduction or disappearance of subjective symptoms. There was an improvement in vision in 68% patients who had impaired vision before the operation. There were no cases of subsequent impairment of vision or ocular motility. Mild relapse was recorded in three cases only and only one patient required unilateral reoperation. Strabismus surgery had to be performed in five patients due to unsatisfactory correction of double vision. It can be concluded that this method of orbital decompression gives very good functional and aesthetical long-term results.
Authors:
R Roncević; D Roncević
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery     Volume:  23     ISSN:  1010-5182     ISO Abbreviation:  J Craniomaxillofac Surg     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-12-05     Completed Date:  1996-12-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8704309     Medline TA:  J Craniomaxillofac Surg     Country:  SCOTLAND    
Other Details:
Languages:  eng     Pagination:  355-62     Citation Subset:  D; IM    
Affiliation:
Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Centre, Beograd, Yugoslavia.
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue / surgery
Adolescent
Adult
Aged
Diplopia / surgery
Esthetics
Ethmoid Bone / surgery
Exophthalmos / surgery*
Eyelids / surgery
Fascia / surgery
Female
Follow-Up Studies
Graves Disease*
Humans
Intraocular Pressure
Male
Middle Aged
Oculomotor Muscles / physiology,  surgery
Orbit / surgery
Periosteum / surgery
Recurrence
Strabismus / surgery
Vision, Ocular

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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