engleski

Endonasal endoscopic orbital decompression in patients with Grave`s ophthalmopathy

Background. The aim of the study was to evaluate the efficacy and safety of endonasal endoscopic orbital decompression (EEOD) in patients with Graves' ophthalmopathy. Methods. EEOD was performed in 17 patients because of active ophthalmopathy, and in 4 patients for esthetic reasons. Preoperative and postoperative examination included visual acuity, examination of the eyelids and cornea, ocular motility, cover testing, Hertel exophthalmometry and applanation tonometry. Results. Visual acuity improved from 0.81±0.28 to 0.92±0.21 (p=0.0032). Retraction of eyelids and exposure keratitis were reduced (p<0.001). Mean proptosis reduction was 4.6±1.7 mm (p<0.001). An average reduction of intraocular pressure was 3.4±3.0 mmHg (p<0.001). New-onset diplopia developed in 8 patients. Diplopia persisted in 9 out of 11 patients with preoperative diplopia. In its correction eye muscle surgery or prisms were used. Conclusions. EEOD improved vision, decreased proptosis and intraocular pressure, and also had favorable cosmetic results in most patients. Postdecompression strabismus and diplopia were successfully managed by either eye muscle surgery or application of prisms.

Grave`s ophthalmopathy; orbital decompression; EEOD

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