Boboridis Kostas G, Gogakos Apostolos, Krassas Gerasimos E
Ophthalmology Department, Aristotle University of Thessaloniki, Greece.
Pediatr Endocrinol Rev. 2010 Mar;7 Suppl 2:222-6.
Thyroid eye disease manifests as orbital inflammation resulting in extraocular muscle enlargement and orbital fat proliferation. This causes exophthalmos, ocular motility impairment and eyelid retraction. Numerous surgical procedures have been introduced for correction of exophthalmos by removal of bony walls. The limited success and high complication rate of the early methods lead to the evolution of an alternative procedure for reduction of retrobulbar volume by removal of intraorbital fat. The indications for this procedure extended from orbital decompression to compressive optic neuropathy with satisfactory results. The moderate complication rate and the fact that orbits with predominant muscle enlargement respond purely to this technique leads to the evolution of a combined procedure with orbital fat removal and bony wall decompression. The scattered published evidence comprising retrospective case series highlights the need for prospective controlled clinical trials in order to improve patient care and clinical practice.
甲状腺眼病表现为眼眶炎症，导致眼外肌增大和眼眶脂肪增生。这会引起眼球突出、眼球运动障碍和眼睑退缩。已经引入了许多外科手术来通过去除骨壁来矫正眼球突出。早期方法的有限成功率和高并发症发生率导致了一种替代手术的发展，即通过去除眶内脂肪来减少球后体积。该手术的适应症从眼眶减压扩展到压迫性视神经病变，效果令人满意。中等的并发症发生率以及以肌肉增大为主的眼眶对该技术有单纯反应这一事实，导致了一种结合眶脂肪去除和骨壁减压的联合手术的发展。包括回顾性病例系列在内的零散已发表证据凸显了进行前瞻性对照临床试验以改善患者护理和临床实践的必要性。
