Changes of Volume Parameters in the Treatment of Graves Ophthalmopathy by Endoscopic Transethmoidal Decompression of the Orbital Inner Wall Combined with Fat Decompression

• Published in: Scanning 2022, Vol.2022, p.8149247-6
• Main Author: Fu, Weina
• Format: Article
• Language: English
• Subjects: Color vision; Cornea; Decompression; Decompression, Surgical - adverse effects; Decompression, Surgical - methods; Diplopia; Diplopia - complications; Diplopia - surgery; Disease; Endoscopy; Exophthalmos - etiology; Exophthalmos - surgery; Eye (anatomy); Graves Ophthalmopathy - complications; Graves Ophthalmopathy - diagnostic imaging; Graves Ophthalmopathy - surgery; Health care facilities; Hospitals; Humans; Lumbar Vertebrae - surgery; Muscles; Ophthalmology; Optic nerve; Regression; Retrospective Studies; Sinuses; Software; Statistical significance; Surgery; Tomography, X-Ray Computed - methods; Treatment Outcome; Visual acuity; Visual fields
• ISSN: 0161-0457; 1932-8745; 1932-8745
• DOI: 10.1155/2022/8149247

Objective. To observe the orbital volume changes and the analysis of surgical effect of Graves orbitopathy (GO) after endoscopic medial wall decompression combined with muscle cone fat. Methods. Twenty-two patients (30 eyes) with Graves orbital disease who visited the Department of Ophthalmology of Ningbo Medical Center from December 2019 to September 2021 were retrospectively collected. All patients were diagnosed as nonorganic active stage before operation, and all of them received endoscopic transethmoidal decompression of the medial orbital wall combined with intramuscular orbital fat decompression due to decreased vision, visual field defect or color vision disorder, and concomitant proptosis. Regular follow-up after operation. The curative effect is judged according to the degree of improvement of visual acuity, color vision, degree of correction of exophthalmos, diplopia, and other complications at 9 months after operation. Orbital CT combined with computer aided measurement software (Mimics 21) was used to measure the changes of orbital volume before and after exophthalmos surgery. The relationship between the value and eyeball regression is analyzed. Results. Preoperative exophthalmos ranged from 17.4 mm to 27.6 mm, with an average of (22.08±2.86) mm. The postoperative exophthalmos was 14-25 mm, with an average of (19.52±3.10) mm. Among them, 7 eyes (23.3%) had exophthalmos regression less than 1 mm, 6 eyes (20%) had a regression of 1-2 mm, 7 eyes (23.3%) had a regression of 2-3 mm, 5 eyes (16.7%) had a regression of 3-4 mm, and 5 eyes (16.7%) had a regression of 4-5.3 mm. The exophthalmos after operation was significantly lower than that before operation, and the difference was statistically significant (t=9.909, P