Abstract:
Background The surgical treatment of thyroid-associated ophthalmopathy (TAO) is carried out by three steps nowadays, that is, orbital decompression, strabismus correction and eyelid surgery. Recent studies have found that orbital decompression combined with strabismus correction or eyelid surgery can shorten the recovery period and has good results as well.
Objective To observe the therapeutic effect of orbital decompression surgery combined with strabismus correction surgery on TAO.
Methods Clinical data about patients with TAO and restrictive strabismus who accepted balanced orbital decompression together with strabismus correction surgery from January 2021 to January 2022 in our center were collected. Main outcome measures included best corrected vision acuity, proptosis, ocular position and ocular movement, diplopia.
Results Totally 17 TAO patients (20 eyes) were enrolled, with 13 males and 4 females, and an average age of 50 ± 8.35 years. Balanced orbital decompression surgery effectively reduced the proptosis in TAO patients (17.75 ± 0.42 mm vs 22.4 ± 0.42 mm, P<0.001), alleviated optic nerve compression and improved visual acuity (LogMAR: 0.22 ± 0.06 vs 0.52 ± 0.09, P =0.031). Strabismus correction surgery effectively alleviated diplopia in 17 eyes, with success rate of 85%. For the 3 failed eyes, young age, smaller interocular exophthalmos difference, unsatisfactory orbital decompression outcome (smaller differences in preoperative and postoperative proptosis), and restrictive strabismus of both eyes might be the adverse factors.
Conclusion Balanced orbital decompression combined with strabismus correction surgery shows satisfactory outcomes for TAO patients, which can be an effective surgical solution for the treatment of TAO with restrictive strabismus.
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