Transconjunctival Fat Removal Combined With Conservative Medial Wall/Floor Orbital Decompression for Graves Orbitopathy


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Abstract

Purpose:To evaluate the utility of transconjunctival fat removal combined with conservative (“strut-sparing”) bony medial/floor orbital decompression for Graves orbitopathy.Methods:Retrospective, noncomparative case series of 52 orbits in 28 patients that underwent decompression using this technique. Preoperative and postoperative exophthalmos, diplopia, logMAR visual acuity, and orbital symmetry were measured.Results:Reduction in exophthalmos up to 8 mm with a mean of 3.3 mm (±1.5 mm) was achieved for decompressed orbits (p < 0.001). Postoperative symmetry within 2 mm was achieved in all patients. Diplopia was improved in 4 patients (14%), unchanged in 23 (82%), and worse in 1 (4%). Mean logMAR visual acuity improved −0.11 units (p = 0.007).Conclusions:Orbital fat removal combined with conservative (“strut-sparing”) bony medial/floor orbital decompression via a single transconjunctival incision is an effective and efficient technique with minimal morbidity.

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