Zhang Shuo, Wu Yu, Wang Yang, Sun Rou, Sun Jing, Fan Xianqun, Li Yinwei, Zhou Huifang
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Eur J Ophthalmol. 2023 Jul;33(4):1724-1732. doi: 10.1177/11206721231152628. Epub 2023 Jan 30.
To compare the surgical outcomes of endoscope-navigation (EN)-assisted orbital decompression and non-EN-assisted orbital decompression for Graves' orbitopathy (GO) and to assess the potential clinical advantage of EN in orbital decompression surgery.
This retrospective cohort study was performed on 227 orbits of 147 GO patients who underwent EN-assisted orbital decompression (185 orbits) or non-EN-assisted orbital decompression (42 orbits). Assessment included proptosis reduction, best-corrected visual acuity (BCVA), diplopia, ocular restriction and surgical complications.
The proptosis reduction in the EN group was 0.9 mm greater than that in the non-EN group in the entire cohort ( = 0.004) and 1.0 mm greater than that in the non-EN group in the propensity score matching cohort ( = 0.025) at 2 years postoperatively. In all, 78.2% of orbits with sight-threatening GO in the EN group and 52.6% of orbits in the non-EN group showed BCVA improvement ( = 0.026). The proportion of patients with improvement in diplopia was significantly greater in the EN group than in the non-EN group ( = 0.026).
EN offers anatomical localization and deep-seated tissue visualization in orbital decompression and significantly improves the surgical outcomes for GO.
比较内镜导航（EN）辅助眼眶减压术与非EN辅助眼眶减压术治疗Graves眼病（GO）的手术效果，并评估EN在眼眶减压手术中的潜在临床优势。
本回顾性队列研究对147例GO患者的227个眼眶进行了研究，这些患者接受了EN辅助眼眶减压术（185个眼眶）或非EN辅助眼眶减压术（42个眼眶）。评估指标包括眼球突出度降低、最佳矫正视力（BCVA）、复视、眼球运动受限和手术并发症。
在整个队列中，术后2年时，EN组的眼球突出度降低比非EN组大0.9 mm（P = 0.004）；在倾向评分匹配队列中，EN组的眼球突出度降低比非EN组大1.0 mm（P = 0.025）。总体而言，EN组中78.2%有视力威胁的GO眼眶和非EN组中52.6%的眼眶BCVA有所改善（P = 0.026）。EN组复视改善患者的比例显著高于非EN组（P = 0.026）。
EN在眼眶减压术中提供解剖定位和深部组织可视化，显著改善GO的手术效果。
