Department of Ophthalmology, Chengdu First People's Hospital, No.18 Wanxiang North Road, Chengdu, 610041, Sichuan Province, China.
Department of Radiology, Chengdu First People's Hospital, Chengdu, Sichuan Province, China.
BMC Ophthalmol. 2021 Apr 13;21(1):176. doi: 10.1186/s12886-021-01911-9.
A new radiological method was used to evaluate the plastic effect of modified transconjunctival orbital fat decompression surgery in patients with inactive thyroid-associated ophthalmopathy.
In this study, 10 inactive patients (14 eyes) with moderate to severe thyroid-associated ophthalmopathy were selected. The patients underwent modified transconjunctival orbital fat decompression surgery. According to the results of a spiral CT scan before and 6 months after the surgery, the INFINITT system workstation was used to measure the eyeball protrusion value. According to the results obtained by the PHLIPS IntelliSpace Portal elliptical area and line segment measurement tools, the standard elliptical vertebral volume formula was used to calculate the muscular cone inner volume. Changes in eyeball protrusion and the inner volume of the muscular cone before and after surgery were examined. Statistical analysis of the correlation between the two parameters was performed.
Radiological measurement results confirmed that removing the orbital fat in the muscle cone during surgery was effective for alleviating eyeball protrusion in patients with thyroid-associated ophthalmopathy (P < 0.05). This surgery caused an obvious change in the muscle cone inner volume (P < 0.05). And there was significant correlation between changes in eyeball protrusion and muscle cone inner volume (r = 0.797, P = 0.0006, P < 0.05).
The radiological assessment method used in this study is simple and easy to implement. For inactive patients with moderate to severe thyroid-associated ophthalmopathy who just want to improve their appearance, the modified orbital fat decompression surgery is worth considering.
采用一种新的放射学方法评估改良经结膜眶隔脂肪减压术对甲状腺相关眼病的整形效果。
本研究选取 10 例(14 只眼)中重度甲状腺相关眼病不活动患者,行改良经结膜眶隔脂肪减压术。根据术前和术后 6 个月螺旋 CT 扫描结果,利用 INFINITT 系统工作站测量眼球突出值,利用 PHILIPS IntelliSpace Portal 椭圆面积和线段测量工具测量,采用标准椭圆椎体容积公式计算肌锥内体积。观察手术前后眼球突出度和肌锥内体积的变化,对两者的相关性进行统计学分析。
影像学测量结果证实,手术中去除肌锥内的眶隔脂肪可有效缓解甲状腺相关眼病患者的眼球突出(P<0.05)。该手术导致肌锥内体积明显变化(P<0.05)。眼球突出度变化与肌锥内体积变化之间存在显著相关性(r=0.797,P=0.0006,P<0.05)。
本研究采用的影像学评估方法简单易行。对于只想改善外观的中重度甲状腺相关眼病不活动患者,改良眶隔脂肪减压术值得考虑。