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S.T. O'Connor, J.D. Perry; Graded Approach to Orbital Decompression for Dysthyroid Orbitopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2223.
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Purpose: To report a graded technique for dysthyroid orbital decompression and the resulting intermediate-term changes in proptosis. The ability to access the inferior wall for decompression through a transcaruncular technique is also described. Methods: Retrospective case series. Charts of twenty-seven consecutive patients (48 eyes) were reviewed for changes in proptosis and strabismus following different types of orbital decompression surgery. Results: Follow-up ranged from 6 to 37 months. Three wall orbital decompression through a lateral and transcaruncular approach was performed in 15 eyes and produced the greatest amount of proptosis reduction. The transcaruncular approach offered easy access to the medial and inferior-medial walls for orbital decompression but generally resulted in less proptosis reduction. Lateral orbital decompression with removal of intraconal fat also yielded less proptosis reduction. Conclusions: A graded approach to orbital decompression for dysthyroid orbitopathy leads to fairly predictable proptosis reduction. While many surgeons use the transcaruncular approach to easily access the medial wall, this approach may also be used to access the inferior wall for orbital decompression.
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