June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Outcomes of Surgical Management of Thyroid Eye Disease: A Single-Centre Retrospective Study
Author Affiliations & Notes
  • Jia Quan Chaung
    Ophthalmology, National University Hospital, Singapore, Singapore
    National University of Singapore, Singapore, Singapore
  • Raghuraj Hegde
    Ophthalmology, National University Hospital, Singapore, Singapore
  • Shantha Amrith
    Ophthalmology, National University Hospital, Singapore, Singapore
  • Inez Wong
    Ophthalmology, National University Hospital, Singapore, Singapore
  • Siew Shuen Chao
    Ophthalmology, National University Hospital, Singapore, Singapore
  • Gangadhara Sundar
    Ophthalmology, National University Hospital, Singapore, Singapore
  • Footnotes
    Commercial Relationships Jia Quan Chaung, None; Raghuraj Hegde, None; Shantha Amrith, None; Inez Wong, None; Siew Shuen Chao, None; Gangadhara Sundar, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 572. doi:
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      Jia Quan Chaung, Raghuraj Hegde, Shantha Amrith, Inez Wong, Siew Shuen Chao, Gangadhara Sundar; Outcomes of Surgical Management of Thyroid Eye Disease: A Single-Centre Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):572.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To study the outcomes of surgical management of thyroid eye disease (TED) in a South East Asian Population

 
Methods
 

Retrospective single-centre case series of all TED patients requiring surgery from Nov 2002 to August 2014 by 2 Oculoplastic surgeons. Data recorded included demographic data, pre-operative and post-operative visual acuity and exophthalmometry for orbital decompression; ocular alignments, revision surgeries for both strabismus and eyelid retraction.

 
Results
 

Of the 336 TED patients seen, 57 patients underwent surgery, 24 male (42.1%) and 33 female (57.9%). Ethnicity: Chinese (73.7%), Malay (14.0%), Indian (5.3%), Others (7.0%). Mean age was 44.2 years (Range 2-81). Surgical indications: Eyelid retraction (52.6%), proptosis (45.7%), cosmesis (33.3%), Exposure Keratopathy (10.5%), Compressive optic neuropathy (8.8%). Surgical procedures included orbital decompression (54.4%), eyelid surgery (52.6%) and strabismus surgery (24.6%). 60 orbits of 31 patients were decompressed: 2-wall (36.7%), pure fat (23.3%) 3-wall (21.7%), 1-wall (18.3%). Medial wall access - retrocaruncular (61.1%) or endonasal (38.9%). Most 2-wall decompressions involved balanced lateral and medial walls (72.7%). The mean reduction in exophthalmometry was 4.5mm (Range -2 - 17) with an improvement of at least one Snellen line in 62.9% of patients. Rate of induced strabismus was 3.2%. Strabismus surgery was performed on 23 eyes of 14 patients of which 1 required surgical revision. Medial rectus was most frequently recessed (34.6%). Diplopia was resolved in 85.7%. Most eyelid surgeries involved the upper lid (55.1%) and Muller’s muscle resection (69.7%). Mean reduction of MRD by 1.5mm. Satisfaction with appearance was achieved in 89.7% while 20.7% of eyelid surgeries required revision. Other eyelid procedures performed included entropion surgery, permanent tarsorrhaphy, epiblephron repair, ptosis repair and blepharoplasty.

 
Conclusions
 

Surgery for TED is not uncommon in our South-East Asian population. Orbital decompression was efficacious in reducing proptosis and improving visual acuity. Complications observed included diplopia and paresthesia. Strabismus and eyelid surgery were used to effectively reduce diplopia and lid retraction respectively. However, they may require revision surgeries to achieve adequate correction.

 
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