Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy

To evaluate the safety and efficacy of orbital decompression combined with strabismus surgery in thyroid-associated orbitopathy (TAO) and identify factors leading to surgical success. A retrospective comparative case series was conducted on 52 patients who were treated with combined orbital decompre...

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Main Authors: Meng-Wei Hsieh, Chih-Kang Hsu, Pao-Cheng Kuo, Hsu-Chieh Chang, Yi-Hao Chen, Ke-Hung Chien
Format: Article
Language:English
Published: MDPI AG 2022-01-01
Series:Journal of Personalized Medicine
Subjects:
Online Access:https://www.mdpi.com/2075-4426/12/2/186
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author Meng-Wei Hsieh
Chih-Kang Hsu
Pao-Cheng Kuo
Hsu-Chieh Chang
Yi-Hao Chen
Ke-Hung Chien
author_facet Meng-Wei Hsieh
Chih-Kang Hsu
Pao-Cheng Kuo
Hsu-Chieh Chang
Yi-Hao Chen
Ke-Hung Chien
author_sort Meng-Wei Hsieh
collection DOAJ
description To evaluate the safety and efficacy of orbital decompression combined with strabismus surgery in thyroid-associated orbitopathy (TAO) and identify factors leading to surgical success. A retrospective comparative case series was conducted on 52 patients who were treated with combined orbital decompression and strabismus surgery. Outcome measurements included perioperative Hertel exophthalmometry and strabismus measurements. Surgical success was defined as binocular single vision (BSV) in the primary and reading positions within 5 prism diopters (PDs). As a result, the average reduction in proptosis was 3.23 mm, with a mean preoperative Hertel measurement of 22.64 mm. Forty-four patients (84.6%) achieved the success criterion and composed the success group. In addition to sex and underlying hyperthyroidism, symmetry of orbitopathy, interocular exophthalmos difference of more than 2 mm, predominant esotropia type, mixed type strabismus, baseline horizontal deviations, baseline vertical deviations, and combination with one-wall decompression surgery were significantly different between the success and failure groups. All complications were mild and temporary. Orbital decompression combined with strabismus surgery produced satisfactory outcomes in selected patients with efficacy and safety. Symmetry between the two eyes with relatively simple strabismus and proptosis ensured surgical success. With experienced surgeons, advanced techniques, and selected patients, this method can serve as an alternative treatment option to minimize the number of surgeries, medical costs and recovery period.
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spelling doaj.art-5aca01f072ce45a7b954c0d5e232abbd2023-11-23T20:39:35ZengMDPI AGJournal of Personalized Medicine2075-44262022-01-0112218610.3390/jpm12020186Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated OrbitopathyMeng-Wei Hsieh0Chih-Kang Hsu1Pao-Cheng Kuo2Hsu-Chieh Chang3Yi-Hao Chen4Ke-Hung Chien5Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan 325, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital Songshan Branch, Songshan, Taipei 105, TaiwanDepartment of Orthopedics, Taipei Veterans General Hospital, Taipei 112, TaiwanDepartment of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, TaiwanTo evaluate the safety and efficacy of orbital decompression combined with strabismus surgery in thyroid-associated orbitopathy (TAO) and identify factors leading to surgical success. A retrospective comparative case series was conducted on 52 patients who were treated with combined orbital decompression and strabismus surgery. Outcome measurements included perioperative Hertel exophthalmometry and strabismus measurements. Surgical success was defined as binocular single vision (BSV) in the primary and reading positions within 5 prism diopters (PDs). As a result, the average reduction in proptosis was 3.23 mm, with a mean preoperative Hertel measurement of 22.64 mm. Forty-four patients (84.6%) achieved the success criterion and composed the success group. In addition to sex and underlying hyperthyroidism, symmetry of orbitopathy, interocular exophthalmos difference of more than 2 mm, predominant esotropia type, mixed type strabismus, baseline horizontal deviations, baseline vertical deviations, and combination with one-wall decompression surgery were significantly different between the success and failure groups. All complications were mild and temporary. Orbital decompression combined with strabismus surgery produced satisfactory outcomes in selected patients with efficacy and safety. Symmetry between the two eyes with relatively simple strabismus and proptosis ensured surgical success. With experienced surgeons, advanced techniques, and selected patients, this method can serve as an alternative treatment option to minimize the number of surgeries, medical costs and recovery period.https://www.mdpi.com/2075-4426/12/2/186hyperthyroidismstrabismusorbital decompression surgery
spellingShingle Meng-Wei Hsieh
Chih-Kang Hsu
Pao-Cheng Kuo
Hsu-Chieh Chang
Yi-Hao Chen
Ke-Hung Chien
Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
Journal of Personalized Medicine
hyperthyroidism
strabismus
orbital decompression surgery
title Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
title_full Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
title_fullStr Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
title_full_unstemmed Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
title_short Factors Predicting the Success of Combined Orbital Decompression and Strabismus Surgery in Thyroid-Associated Orbitopathy
title_sort factors predicting the success of combined orbital decompression and strabismus surgery in thyroid associated orbitopathy
topic hyperthyroidism
strabismus
orbital decompression surgery
url https://www.mdpi.com/2075-4426/12/2/186
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