Hill Robert H, Czyz Craig N, Bersani Thomas A
Department of Ophthalmology, SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY 13210, USA.
ScientificWorldJournal. 2012;2012:312361. doi: 10.1100/2012/312361. Epub 2012 Apr 30.
To evaluate the reduction in proptosis, incidence of postoperative diplopia, and postoperative globe symmetry after transcaruncular medial wall decompression in patients with unilateral Graves ophthalmopathy.
Retrospective review of 16 consecutive patients who underwent unilateral transcaruncular medial wall orbital decompression from 1995 to 2007. The diagnosis of Graves ophthalmopathy was based on history and clinical findings including proptosis, lagophthalmos, lid retraction, motility restriction, and systemic thyroid dysfunction.
The mean reduction in proptosis was 2.3 mm. The mean difference in exophthalmometry preoperatively between the two eyes in each patient was 3.1 mm whereas postoperatively the mean difference was 1.1 mm (P = 0.0002). Eleven of 16 patients (69%) had 1 mm or less of asymmetry postoperatively. There was no statistically significant difference in the incidence of diplopia pre and postoperatively (P = 1.0).
Medial wall orbital decompression is a safe and practical surgical approach for patients with unilateral Graves orbitopathy. The procedure carries a low risk of morbidity and yields anatomic retrusion of the globe that is comparable to other more invasive methods and may yield more symmetric postoperative results.
评估经泪阜内侧壁减压术对单侧格雷夫斯眼病患者眼球突出度的降低程度、术后复视发生率及术后眼球对称性。
回顾性分析1995年至2007年连续接受单侧经泪阜内侧壁眼眶减压术的16例患者。格雷夫斯眼病的诊断基于病史及临床表现，包括眼球突出、眼睑闭合不全、眼睑退缩、眼球运动受限及全身甲状腺功能障碍。
眼球突出度平均降低2.3毫米。每位患者术前两眼眼球突出度测量的平均差值为3.1毫米，而术后平均差值为1.1毫米（P = 0.0002）。16例患者中有11例（69%）术后眼球不对称度在1毫米或以内。术前和术后复视发生率无统计学显著差异（P = 1.0）。
内侧壁眼眶减压术对于单侧格雷夫斯眼眶病患者是一种安全且实用的手术方法。该手术并发症风险低，可使眼球实现解剖性后缩，与其他更具侵入性的方法相当，且术后结果可能更对称。
