Endocrine exophthalmos and controversial methods of orbital decompression

In cases of severe endocrine ophthalmopathy, conservative therapy often fails to produce satisfactory results. Therefore, surgical treatment is used, in particular orbit decompression, which triggers controversial opinions in the literature. Purpose: to present the authors’ own method of orbital decompression, clinical observations, and the results achieved over 30 years of experience. Material and methods. 119 patients aged 17-73 with severe endocrine ophthalmopathy were operated in accordance with the authors’ technique of orbital decompression. In the course of these operations, three walls of the orbit are partially resected, periorbital, intraorbital and retrobulbar fat is removed, eyelids are simultaneously corrected for deformities and retracted. Results. After the operation, all patients showed a significant reduction of exophthalmos (by 5-11 mm, averagely 7 mm), and IOP, a marked improvement in extraocular muscle functions, and considerable reduction or disappearance of subjective symptoms. Vision acuity improved in 68 % patients. Mild relapse of exophtalmos was noted in three cases only, and only one patient required a repeated unilateral operation. Strabismus surgery had to be performed in 6 patients (5 %) due to correction of residual double vision. Conclusion. It can thus be concluded that our method or orbital decompression gives very good functional and aesthetic long-term results // Russian Ophthalmological Journal, 2016; 4: 37-45 . doi: 10.21516/2072-0076-2016-9-4-37-45