Kakizaki Hirohiko, Takahashi Yasuhiro, Ichinose Akihiro, Iwaki Masayoshi, Selva Dinesh, Leibovitch Igal
Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan;
Clin Ophthalmol. 2011;5:865-9. doi: 10.2147/OPTH.S20855. Epub 2011 Jun 24.
To evaluate the surgical outcome of deep lateral orbital decompression with or without rim removal.
Retrospective case series.
Thirty-two patients (47 orbits) with Graves' orbitopathy who underwent simple deep lateral decompression or balanced lateral plus medial decompression. Of the 14 patients (24 orbits) who underwent simple deep lateral decompression, 8 (13 orbits) had temporary rim removal and in 6 (11 orbits) the rim was left intact. Of the 18 patients (23 orbits) who underwent a balanced decompression, 7 (9 orbits) had temporary rim removal and in 11 (14 orbits) the rim was left intact. The amount of postoperative reduction in proptosis was compared among these four groups.
The average reduction in proptosis in the simple deep lateral decompression group was 5.73 mm (range: 4.0-8.0 mm) in the rim removal group and 4.09 mm (range: 2.5-6.0 mm) in the intact rim group (P = 0.005). The average reduction in proptosis in the balanced decompression group was 6.39 mm (range: 5.0-8.5 mm) in the rim removal group and 5.07 mm (range: 3.0-8.0 mm) in the intact rim group (P = 0.039). There was no statistically significant difference in proptosis reduction between the simple deep lateral decompression with rim removal group and the balanced decompression with an intact rim group (P = 0.220).
The rim removal approach allows a more effective decompression than the intact rim approach. Simple deep lateral decompression with rim removal approach has a similar effect to balanced decompression through an intact rim.
评估有或无眶缘切除的深部外侧眼眶减压术的手术效果。
回顾性病例系列。
32例（47只眼眶）格雷夫斯眼眶病患者接受了单纯深部外侧减压术或平衡外侧加内侧减压术。在接受单纯深部外侧减压术的14例患者（24只眼眶）中，8例（13只眼眶）进行了临时眶缘切除，6例（11只眼眶）眶缘未切除。在接受平衡减压术的18例患者（23只眼眶）中，7例（9只眼眶）进行了临时眶缘切除，11例（14只眼眶）眶缘未切除。比较这四组术后眼球突出度的降低量。
单纯深部外侧减压术组中，眶缘切除组眼球突出度平均降低5.73mm（范围：4.0 - 8.0mm），眶缘未切除组为4.09mm（范围：2.5 - 6.0mm）（P = 0.005）。平衡减压术组中，眶缘切除组眼球突出度平均降低6.39mm（范围：5.0 - 8.5mm），眶缘未切除组为5.07mm（范围：3.0 - 8.0mm）（P = 0.039）。眶缘切除的单纯深部外侧减压术组与眶缘未切除的平衡减压术组之间在眼球突出度降低方面无统计学显著差异（P = 0.220）。
眶缘切除法比眶缘未切除法能实现更有效的减压。眶缘切除的单纯深部外侧减压术与眶缘未切除的平衡减压术效果相似。
