Sasim Inna V, de Graaf Mieke E L, Berendschot Tos T J M, Kalmann Rachel, van Isterdael Chantal, Mourits Maarten P
Division of Ophthalmology, Department of Surgical Specialities, University Medical Center Utrecht, Utrecht, The Netherlands.
Ophthalmology. 2005 Jul;112(7):1310-5. doi: 10.1016/j.ophtha.2005.01.049.
To compare 2 different approaches for 3-wall orbital decompression in patients with disfiguring proptosis due to Graves' orbitopathy, and to determine which technique is preferable.
Retrospective nonrandomized study with a concurrent comparison group.
Charts of 74 consecutive patients with disfiguring proptosis due to Graves' orbitopathy who underwent coronal (46) or swinging eyelid (28) decompression between January 1, 2000 and January 1, 2004 were studied retrospectively. Patients with dysthyroid optic neuropathy were excluded.
We analyzed the following parameters: proptosis reduction, ocular motility, number of additional operations, number and kind of complications, patients' satisfaction, patients' estimation of numbness or abnormal sensations in the field of operation and surgical scars, and duration of hospitalization time.
Reduction of proptosis, changes in eye motility, and duration of hospitalization.
Mean proptosis reductions were 4.8 mm (range, 1-11) after coronal decompression and 5.6 mm (range, 0-8) after swinging eyelid decompression (P = 0.025). Patients who were operated by the swinging eyelid approach had no more deteriorated motility and a shorter hospitalization time. Complications were seen rarely. Both groups of patients showed high satisfaction scores.
Relative to the coronal approach, swinging eyelid decompression results in at least the same proptosis reduction, no greater motility disturbance, and a shorter hospitalization time.
比较两种不同的三壁眼眶减压方法，用于治疗因格雷夫斯眼眶病导致的毁容性眼球突出患者，并确定哪种技术更可取。
带有同期对照组的回顾性非随机研究。
对2000年1月1日至2004年1月1日期间连续74例因格雷夫斯眼眶病导致毁容性眼球突出并接受冠状（46例）或摆动眼睑（28例）减压手术的患者病历进行回顾性研究。排除甲状腺功能异常性视神经病变患者。
我们分析了以下参数：眼球突出度降低情况、眼球运动、额外手术次数、并发症的数量和种类、患者满意度、患者对手术区域麻木或异常感觉以及手术瘢痕的评估，以及住院时间。
眼球突出度降低、眼球运动变化和住院时间。
冠状减压术后平均眼球突出度降低4.8毫米（范围1 - 11毫米），摆动眼睑减压术后为5.6毫米（范围0 - 8毫米）（P = 0.025）。采用摆动眼睑入路手术的患者眼球运动没有进一步恶化，住院时间更短。并发症很少见。两组患者的满意度评分都很高。
相对于冠状入路，摆动眼睑减压导致的眼球突出度降低至少相同，眼球运动障碍不更大，且住院时间更短。
