Balanced Orbital Decompression in Patients with Grave’s orbitopathy – possible Risk Factors for postoperative Diplopia in Primary Position

Introduction Balanced orbital decompression is indicated in patients with Grave’s Orbitopathy (GO) in case of insufficient conservative treatment. One frequent complication is the new onset of diplopia. The risk factors for this complication have not been completely identified yet.

Methods In a retrospective study, we analyzed clinical data of patients who received orbital decompression due to GO between 2012 and 2018. Exclusion criteria were incomplete data, revisions and only medial or lateral decompressions. Correlations between postoperative diplopia and preoperative double vision, reduction of proptosis, indication for surgery, thickness of eye muscles and duration of the disease were analyzed.

Results We included 185 patients (341 orbitae), who were separated in two groups without (-DB) and with (+DB) postoperative diplopia. Since preoperative double vision showed a high correlation to postoperative diplopia, additionally a subgroup (+DB neu) with new onset diplopia was analyzed. Reduction of proptosis was higher in the group with postoperative diplopia (-DB = 4,7mm, +DB 5,7mm, +DBneu 6,5mm). Both groups with diplopia showed higher rates of optical nerve compression (-DB 17 %, +DB 28 %, +DBneu 28 %). There was no difference in patients’ age and gender.

Discussion Patients with preoperative double vision have a high risk for postoperative diplopia. Additionally, patients with high need for extended proptosis reduction or who suffer from preoperative optical nerve compression are at higher risk for the development of postoperative diplopia.

Poster-PDF A-1597.PDF

Publication History

Article published online:
10 June 2020