Roncevic Radmilo
Clinic for Burns, Plastic and Reconstructive Surgery, Clinical Center of Serbia, Belgrade, Serbia.
J Craniofac Surg. 2008 May;19(3):628-36. doi: 10.1097/SCS.0b013e31816adca2.
Conservative therapy in cases of severe thyroid ophthalmopathy has not given satisfactory results. Because of this, surgical treatment, that is, orbital decompression, is now being used with increasing frequency. Since the end of 1986 until the end of 2006, 103 patients with severe thyroid ophthalmopathy have been treated by personal 3-wall orbital decompression combined with removal of the periorbital, intraorbital, and retrobulbar fat, as well as with correction of eyelid retraction and deformities. After operation, all patients showed a significant reduction of exophthalmos (5-11 mm; 7.2 mm on average), reduction of intraocular pressure, marked improvement in ocular muscle function, and considerable reduction or disappearance of subjective symptoms. There was an improvement in vision in 68% patients who had impaired vision before the operation. There were no cases of subsequent impairment of ocular motility. Mild relapse of exophthalmos was recorded in 3 cases only, and only 1 patient required unilateral reoperation. Strabismus surgery had to be performed in 6 patients due to unsatisfactory correction of double vision. It can be concluded that this method of orbital decompression gives constantly very good functional and aesthetic long-term results and allows rapid recovery.
重度甲状腺眼病的保守治疗效果并不理想。因此，手术治疗，即眼眶减压术，目前的使用频率越来越高。从1986年底到2006年底，103例重度甲状腺眼病患者接受了本人实施的三壁眼眶减压术，同时去除眶周、眶内和球后脂肪，并矫正眼睑退缩和畸形。术后，所有患者的眼球突出度均显著降低（5 - 11毫米；平均7.2毫米），眼压降低，眼肌功能明显改善，主观症状显著减轻或消失。术前视力受损的患者中，68%的患者视力得到改善。没有出现随后眼球运动障碍的病例。仅3例记录有轻度眼球突出复发，仅1例患者需要单侧再次手术。6例患者因复视矫正不充分而不得不进行斜视手术。可以得出结论，这种眼眶减压方法能持续产生非常好的长期功能和美学效果，并能使患者迅速康复。
