Endoscopic orbital fat decompression for the management of proptosis in Grave's orbitopathy using a laryngeal skimmer blade

Eye (Lond). 2019 Dec;33(12):1924-1929. doi: 10.1038/s41433-019-0519-7. Epub 2019 Jul 8.


Backgrounds/objectives: Intraoperative handling and manipulation of orbital fat remains a challenge to orbital surgeons. We present a case series of endoscopic orbital fat decompression with medial orbital wall decompression for proptosis management in Grave's orbitopathy, describing a technique for fat excision using a laryngeal skimmer blade, reporting clinical and surgical outcomes, and complications.

Subjects/methods: All patients who underwent endoscopic orbital fat decompression, with medial orbital wall decompression, for proptosis management in Grave's orbitopathy between 2011 and 2018, under the care of a single surgeon, were included in this retrospective interventional case series.

Results: Nineteen patients were included in this study. Using a laryngeal skimmer blade, orbital fat was excised endoscopically at the time of medial orbital wall decompression. The mean volume of orbital fat excised was 1.45 ± 0.63 ml and the mean reduction in proptosis was 4.5 ± 1.02 mm. There were no intraoperative complications.

Conclusions: In this study, we describe our experience of using a laryngeal skimmer blade as a method of excising orbital fat for orbital decompression in patients with proptosis secondary to Grave's orbitopathy.

MeSH terms

  • Adipose Tissue / surgery*
  • Adult
  • Aged
  • Decompression, Surgical / instrumentation*
  • Endoscopy / methods*
  • Equipment Design
  • Exophthalmos / diagnosis
  • Exophthalmos / etiology
  • Exophthalmos / surgery*
  • Female
  • Follow-Up Studies
  • Graves Ophthalmopathy / complications*
  • Graves Ophthalmopathy / diagnosis
  • Graves Ophthalmopathy / surgery
  • Humans
  • Male
  • Middle Aged
  • Orbit / diagnostic imaging
  • Orbit / surgery*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome