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Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Authors Ismailova DS, Belovalova IM, Grusha YO, Sviridenko NY

Received 2 February 2018

Accepted for publication 21 June 2018

Published 1 October 2018 Volume 2018:11 Pages 243—249


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Dilyara S Ismailova,1 Irina M Belovalova,2 Yaroslav O Grusha,1,3 Natalya Y Sviridenko2

1Research Institute of Eye Diseases, Moscow, Russia; 2Endocrinology Research Centre, Moscow, Russia; 3I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Abstract: Orbital decompression is a surgical procedure aimed at increasing the orbital volume and/or decreasing the volume of the orbital fat. The indications for orbital decompression are determined in the course of thorough eye examination. An important objective of examination of a patient with thyroid eye disease (TED) is determination of inflammation activity and severity. Orbital decompression is a surgical procedure that can be performed in both the active and non-active stages of the disease. However, the indications for the surgery in these cases are different. Optic neuropathy and severe corneal disease are threatening complications that may lead to permanent visual loss and generally occur in the presence of active orbital inflammation. If treatment with high-dose corticosteroids has proven ineffective, an urgent surgical procedure consisting of orbital decompression and, in case of involvement of the cornea, eyelid and corneal surgery has to be performed. Owing to significant progress in technology, improvement of methods and accumulated experience over the past decade, the indications for bone orbital decompression have extended compared to the time when this procedure was used only in patients with extremely severe TED. The most common complication of the orbital decompression is the development or deterioration of previously existing binocular diplopia and strabismus. In addition, other parameters may change as well, including the position of the globe, the eyelids, the angle of deviation of the eye, and intraocular pressure. Thus, bone orbital decompression is a major step of a comprehensive, often multistage, system of rehabilitation of patients with severe refractory TED.

Keywords: Graves’ disease, thyroid eye disease, orbital decompression, ophthalmopathy, corneal ulcer, tarsoraphy

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