Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2024 Aug 5;87(5):e20230296. doi: 10.5935/0004-2749.2023-0296. eCollection 2024.
To compare inferomedial wall orbital decompression to balanced medial plus lateral wall orbital decompression in patients with Graves' orbitopathy in the inactive phase with regard to exophthalmos reduction and the effects on quality of life.
Forty-two patients with inactive Graves' orbitopathy were randomly divided into two groups and submitted to one of two orbital decompression techniques: inferomedial wall orbital decompression or medial plus lateral wall orbital decompression. Preoperative and postoperative assessments included Hertel's exophthalmometry and a validated Graves' orbitopathy quality of life questionnaire. The results of the two groups were compared.
Compared to preoperative measurement, exophthalmos reduction was statistically significant in both groups (p<0.001) but more so in patients undergoing medial plus lateral wall orbital decompression (p=0.010). Neither orbital decompression techniques increased the visual functioning subscale score on the Graves' orbitopathy quality of life questionnaire (inferomedial wall orbital decompression p=0.362 and medial plus lateral wall orbital decompression p=0.727), but a statistically significant difference was observed in the score of the appearance subscale in patients submitted to medial plus lateral wall orbital decompression (p=0.006).
Inferomedial wall orbital decompression is a good alternative for patients who do not require large exophthalmos reduction. However, medial plus lateral wall orbital decompression offers greater exophthalmos reduction and greater improvement in appearance (higher Graves' orbitopathy quality of life questionnaire scores), making it a suitable option for esthetic-functional rehabilitation.
比较在静止期 Graves 眼病患者中，内侧壁联合下壁眶减压术与单纯内侧壁眶减压术治疗突眼的效果。
42 例静止期 Graves 眼病患者随机分为两组，分别行内侧壁联合下壁眶减压术或单纯内侧壁眶减压术。术前和术后评估包括 Hertel 突眼计和经过验证的 Graves 眼病生活质量问卷。比较两组的结果。
与术前测量值相比，两组突眼度均有统计学意义（p<0.001），但内侧壁联合下壁眶减压组更为显著（p=0.010）。两种眶减压技术均未增加 Graves 眼病生活质量问卷中视觉功能子量表的评分（内侧壁联合下壁眶减压组 p=0.362，内侧壁眶减压组 p=0.727），但内侧壁联合下壁眶减压组在外观子量表的评分上存在统计学差异（p=0.006）。
对于不需要明显突眼度降低的患者，内侧壁眶减压术是一种较好的选择。然而，内侧壁联合下壁眶减压术可提供更大的突眼度降低和更好的外观改善（更高的 Graves 眼病生活质量问卷评分），是美学和功能康复的理想选择。
