McCord C D
Ophthalmology. 1981 Jun;88(6):533-41.
A surgical procedure is described to perform orbital decompression in patients suffering from orbitopathy in Graves' Disease. The decompression technique employs exposure of the orbit through a lateral incision and an inferior fornix incision. These combined incisions with exposure can be used to perform an antral-ethmoidal decompression (two-wall decompression) or an antral-ethmoidal-lateral wall decompression (three-wall decompression). This present series contains 34 patients who underwent decompression through a 2 1/2-year period ending October 1980. The results of decompression were quantitated by measuring the retroplacement of the globe and in patients with compressive optic neuropathy by improvement in vision. The retroplacement of the globe with the antral-ethmoidal (two-wall decompression) was 4 to 7 mm (average 6 mm), and the retroplacement was 6 to 8 mm in four patients who underwent antral-ethmoidal-lateral decompression (three-wall decompression). All patients with compressive optic neuropathy improved to a final visual acuity of 20/40 or better. Five of 11 patients, with compressive optic neuropathy required postoperative super-voltage irradiation to reach this acuity. Fifty percent of the patients undergoing antral-ethmoidal decompression for proptosis required additional eyelid surgery with recession of upper lid retractors.
本文描述了一种针对患有格雷夫斯病眼眶病患者进行眼眶减压的外科手术方法。该减压技术通过外侧切口和下穹窿切口暴露眼眶。这些联合切口及暴露方式可用于进行上颌筛窦减压（两壁减压）或上颌筛窦-外侧壁减压（三壁减压）。本系列研究纳入了34例患者，他们在截至1980年10月的2年半时间内接受了减压手术。通过测量眼球后移情况对减压效果进行量化评估，对于患有压迫性视神经病变的患者，则通过视力改善情况进行评估。采用上颌筛窦（两壁减压）手术时，眼球后移4至7毫米（平均6毫米），而在接受上颌筛窦-外侧壁减压（三壁减压）的4例患者中，眼球后移6至8毫米。所有患有压迫性视神经病变的患者最终视力均提高到20/40或更好。11例患有压迫性视神经病变的患者中有5例需要术后进行超电压照射才能达到这一视力。因眼球突出接受上颌筛窦减压手术的患者中有50%需要额外进行眼睑手术，即上睑提肌后徙术。
