The management of patients with thyroid eye disease after bilateral orbital 3 wall decompression

Strabismus. 2011 Jun;19(2):35-7. doi: 10.3109/09273972.2011.575432.


Introduction: Thyroid eye disease is the most common cause of unilateral and bilateral proptosis in adults. Orbital decompression surgery may cause and/or worsen a pre-existing ocular motility disorder.

Methods: A retrospective review was carried out of all bilateral 3 wall orbital decompressions for severe thyroid eye disease performed between January 2002 and December 2004 by one surgeon. Subsequent surgeries were recorded.

Results: Seventy-four patients were identified, 59 (80%) females and 15 (20%) males. Mean age at the time of decompression was 46 years. Fifteen (20%) patients complained of diplopia due to strabismus prior to decompression surgery and 20 (27%) developed new diplopia postsurgery. Twenty patients (27%) required no further intervention following decompression surgery; the remainder underwent an average of 2.5 procedures. Strabismus surgery was performed in 32 (43%) patients. The mean time from the decompression to first strabismus surgery was 12 months. Forty-three (58%) patients underwent lid surgery. The mean time from decompression to first lid surgery was 16 months.

Conclusion: This study demonstrates how this group of complex patients required multiple surgical procedures within an extended timescale, therefore requiring several in- and outpatient visits.

MeSH terms

  • Adult
  • Aged
  • Decompression, Surgical* / adverse effects
  • Diplopia / etiology
  • Eyelids / surgery
  • Female
  • Graves Ophthalmopathy / complications
  • Graves Ophthalmopathy / surgery*
  • Humans
  • Male
  • Middle Aged
  • Orbit / surgery*
  • Postoperative Care*
  • Postoperative Complications
  • Retrospective Studies
  • Strabismus / complications
  • Strabismus / surgery
  • Young Adult