Fatourechi V, Garrity J A, Bartley G B, Bergstralh E J, DeSanto L W, Gorman C A
Division of Endocrinology, Metabolism, and Internal Medicine, Mayo Clinic, Rochester, Minnesota, Canada.
Ophthalmology. 1994 May;101(5):938-42.
Transantral orbital decompression is effective treatment for excessive proptosis and optic neuropathy due to Graves ophthalmopathy. In these sight-threatening circumstances, patients willingly accept the side effects of orbital decompression. When transantral orbital decompression is performed for cosmetic indications, patients' acceptance of side effects may be different. This study reports detailed results of transantral decompression for 34 patients in whom the indications were primarily cosmetic.
The medical records of 34 patients with Graves ophthalmopathy who had transantral orbital decompression primarily for cosmetic indications were reviewed. Preoperative and postoperative physical features of the eyes were compared. Long-term assessment was formulated from follow-up examination and a follow-up questionnaire.
The most notable improvement was in the reduction of proptosis (mean decrease, 5.2 mm). The frequency of asymmetry of proptosis, however, did not improve. Asymmetry was more than 1 mm in 44% of patients preoperatively and in 54% postoperatively. Although the palpebral fissure was decreased by an average of 2.7 mm, upper lid retraction became worse in 12 (43%) of 28 eyes. Of 15 patients who had no diplopia preoperatively, continuous diplopia developed postoperatively in 73%. The patients underwent a total of 37 eye muscle operations and 31 eyelid operations after decompression. Of 29 patients who responded to a long-term follow-up questionnaire, 69% were satisfied with the appearance of the eyes and 31% found it acceptable. No patient was dissatisfied. Symptomatic diplopia was present in 6.9% of patients at the time of the follow-up questionnaire.
Transantral orbital decompression performed for cosmetic indications in Graves ophthalmopathy may need to be followed by eye muscle and lid operations. These procedures result in a high degree of patient satisfaction. However, a small percentage of patients experience persistent diplopia, despite multiple eye muscle procedures.
经鼻窦眼眶减压术是治疗Graves眼病所致眼球过度突出和视神经病变的有效方法。在这些威胁视力的情况下，患者愿意接受眼眶减压术的副作用。当经鼻窦眼眶减压术用于美容目的时，患者对副作用的接受程度可能不同。本研究报告了34例主要因美容目的而行经鼻窦减压术患者的详细结果。
回顾性分析34例主要因美容目的而行经鼻窦眼眶减压术的Graves眼病患者的病历。比较术前和术后眼睛的体征。通过随访检查和随访问卷进行长期评估。
最显著的改善是眼球突出度降低（平均降低5.2mm）。然而，眼球突出不对称的发生率并未改善。术前44%的患者眼球突出不对称超过1mm，术后为54%。虽然睑裂平均缩小2.7mm，但28只眼中有12只（43%）上睑退缩加重。术前无复视的15例患者中，术后73%出现持续性复视。减压术后患者共接受了37次眼肌手术和31次眼睑手术。在29例回复长期随访问卷的患者中，69%对眼部外观满意，31%认为可以接受。没有患者不满意。随访问卷时6.9%的患者有症状性复视。
Graves眼病患者为美容目的而行经鼻窦眼眶减压术可能需要后续进行眼肌和眼睑手术。这些手术使患者满意度较高。然而，尽管进行了多次眼肌手术，仍有一小部分患者存在持续性复视。
