Yeo Joon Hyung, Park Sang Joon, Chun Yeon Sook, Kim Jee Taek, Moon Nam Ju, Lee Jeong Kyu
Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, South Korea, 06974.
Department of Radiology, Seoul National University, College of Medicine, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2017 Apr;255(4):825-830. doi: 10.1007/s00417-017-3601-5. Epub 2017 Jan 28.
The purpose was to investigate the effects of orbital decompression surgery on postoperative changes in interpupillary distance (IPD) and angle kappa in patients with thyroid-associated orbitopathy (TAO).
In patients with TAO who underwent orbital decompression surgery between January 1, 2014 and February 21, 2016, we measured exopthalmometry, IPD, inner intercanthal distance (IICD) and outer intercanthal distance (OICD) using a computer software program and angle kappa with an ORB scan II. We then analyzed preoperative and 3-month postoperative exophthalmometry, IPD, IICD, OICD and angle kappa to evaluate changes in eye position or rotation of the eyeball following orbital decompression surgery.
Fifty-four patients (35 women and 19 men) with a mean age of 34.59 (range, 16-64 years) were enrolled in this study. After decompression surgery, the IPD was significantly decreased by 1.76 mm (preoperative, 63.14 ± 3.93 mm; postoperative, 61.38 ± 3.84 mm; P < 0.001), but angle kappa, IICD, and OICD did not vary significantly (P = 0.814, P = 0.635 and P = 0.092, respectively).
A significant decrease in IPD was noted after orbital decompression in patients with TAO. However, there was no significant change in angle kappa. Therefore, the mechanism of change in the IPD is not an inward rotation of the eyeball, but rather an actual dorsal shift causing a wedging of the eye position itself within the orbit.
本研究旨在探讨眼眶减压手术对甲状腺相关性眼病（TAO）患者术后瞳孔间距（IPD）及kappa角变化的影响。
选取2014年1月1日至2016年2月21日期间接受眼眶减压手术的TAO患者，使用计算机软件程序测量眼球突出度、IPD、内眦间距（IICD）和外眦间距（OICD），并使用ORB scan II测量kappa角。然后分析术前及术后3个月的眼球突出度、IPD、IICD、OICD和kappa角，以评估眼眶减压手术后眼位或眼球旋转的变化。
本研究共纳入54例患者（35例女性，19例男性），平均年龄34.59岁（范围16 - 64岁）。减压手术后，IPD显著降低1.76 mm（术前63.14±3.93 mm；术后61.38±3.84 mm；P < 0.001），但kappa角、IICD和OICD无显著变化（分别为P = 0.814、P = 0.635和P = 0.092）。
TAO患者眼眶减压术后IPD显著降低。然而，kappa角无显著变化。因此，IPD变化的机制不是眼球向内旋转，而是眼球实际向后移位导致眼球在眼眶内位置呈楔形改变。
