Transnasal endoscopic orbital decompression in Graves’ disease: experience of 20 years in Hospital of Egas Moniz
DOI:
https://doi.org/10.34631/sporl.2077Keywords:
Graves’ disease, thyroid orbitopathy, endoscopic orbital decompression, diplopiaAbstract
Introduction and goals: Graves' orbitopathy is the most common extrathyroidal manifestation of Graves' disease and manifests as proptosis, exposure keratitis and compressive optic neuropathy. Its treatment, particularly when refractory to medical therapies, involves surgical decompression of the orbit. The objective of this work is to evaluate the effectiveness and safety of transnasal endoscopic decompression of the orbit.
Methods: Retrospective analysis of patients who underwent this procedure between January 2001 and December 2022. Patients were evaluated before and after surgery regarding the presence of ophthalmological symptoms, and changes in the following parameters: visual acuity, intraocular pressure and proptosis. Surgical complications were also recorded.
Results: The study included 40 orbits from 27 patients. In the ophthalmological evaluation, on average, intraocular pressure reduced by 2.7 mmHg (p < 0.001), proptosis reduced by 3.98 mm (p < 0.05) and visual acuity improved by 2/10 of vision (p < 0.001). No complications were recorded except for new diplopia in 7 patients (25.9%).
Conclusion: Transnasal endoscopic decompression of the orbit showed good results in terms of safety and efficacy, although the development of postoperative diplopia is not negligible.
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