Galvis A, Bernal G, Salcedo-Casillas G

Language: Spanish
References: 21
Page: 5-12
PDF size: 294.72 Kb.

ABSTRACT

Purpose: To analyze the results of orbital decompression in thyroid-related orbitopathy.
Design: A retrospective, observational, descriptive study.
Methods: All orbital decompressions for thyroid-related orbitopathy performed at "Asociacion para Evitar la Ceguera en Mexico – Hospital Dr. Luis Sanchez Bulnes" during the period 1995 through 2002 and with at least 3 months postoperative follow up were analyzed. Preoperative data was collected regarding visual acuity, intraocular pressure, presence of diplopia /strabismus/ keratopathy, exophthalmometry, presence or absence of compressive optic neuropathy. Data was collected with regards to surgical procedure, number of walls decompressed, additional intraoperative procedures and surgical complications. Postoperative data included the same variables as the preoperative examination. Cases were subdivided based on preoperative exophthalmometry into 3 groups: Group I (‹ 22 mm), Group II (22 – 25 mm) and Group III (› 25 mm). Statistical analysis included Student t-tests and anova for comparisons of means, chi-square tests for bivariate analysis. Logistic regression was employed to determine success predictors.
Results: A total of 107 orbits from 62 patients met the study criteria. Mean age at time of surgery was 50.5 years (13-76 years). Diabetes was present in 11.7% of patients. Mean postoperative follow up time was 13.3 months (3 – 110 mos.). Optic neuropathy was the surgical indication in 46.7% of the cases. Disfiguring proptosis was the surgical indication in 15% of the cases.
Conclusion: The decision to perform orbital decompression in thyroid related orbitopathy should not only rely on exophthalmometry. It is necessary to review other predictor factors like age, sex, race, smoking, diabetes, thyroid hormones, and degree of orbitopathy, myopathy and optic neuropathy.

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