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ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2013, Number 3

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Cir Plast 2013; 23 (3)

Treatment of hyperthyroid ophthalmopathy, by means of orbital decompression with osteotomy in U three walls modified. Preliminary report

Vallarta RRA, López-Robles JL, Reyes ELG

Language: Spanish
References: 22
Page: 146-152
PDF size: 323.83 Kb.


ABSTRACT

Thyroid orbitopathy is one of the most frequent extra thyroid manifestations of Graves’s disease. It usually occurs in hyperthyroid patients, but has also been described in hypothyroid patients, euthyroid and Hashimoto thyroiditis. Independent of the aesthetic changes, patients may suffer exposure keratitis, diplopia, retrobulbar pain, compression of the optic nerve and blindness. Treatment depends on the stage of the disease and can be conservative and surgical. Orbital decompression is the mainstay in the surgical treatment of the thyroid orbitopathy and it is the most effective method for severe compressive neuropathy. The objective of this paper is to present our experience with a three-wall U osteotomy eliminating periorbital, orbital and retrobulbar fat and to present an alternative to the surgical treatment of thyroid ophthalmopathy. We present two patients with severe thyroid ophthalmopathy that were treated by the three-wall orbital decompression combined with the removal of the periorbital, intraorbital, and retrobulbar fat, as well as with the correction of eyelid retraction and deformities. After surgery, the patients showed a significant reduction of exophthalmos, a marked improvement in ocular muscle function, and a considerable reduction or disappearance of the subjective symptoms. There were no cases of subsequent impairment of ocular motility, or relapse of exophthalmos. One patient presented transitory lagoftalmos, and a conservative treatment was given, with good result. Preliminarily, this method of orbital decompression has good functional and cosmetic results and enables rapid recovery, although it is still necessary to increase the sample for more significant value.


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