Diplopia after orbital decompression by Graves orbitopathy – what remains despite strabismus surgery?

Introduction Bony orbital decompression can be used for surgical treatment of endocrine orbitopathy. Diplopia is a complication. This study examined the number of cases in which further surgical correction using a strabismus surgery was required and how many patients continued to suffer from diplopia after treatment was completed.

Methods Patients with endocrine orbitopathies, who received an orbital decompression during 2012 and 2019 at the ENT of the university clinic of Essen, were included in this study. Only patients without diplopia before orbital decompression and with strabismus postoperative were included. It was analysed if patients still had diplopia after strabismus surgery.

Results The data from 76 patients (female: N=68) were evaluated. The average age was 47,45 years (± standard deviation 11,42 years). After orbital decompression 30 patients squinted intermittently and 46 permanently. Strabismus was treated conservatively in 18 patients (23,7%) e.g., using prism glasses. 47 patients (61,8%) did not squint after strabismus surgery. 9 patients (11,8%) squinted intermittently and 2 patients (2,6%) permanently.

Conclusion In almost every case, permanent strabismus after orbital decompression can be resolved with strabismus surgery or prism glasses. Only 2 out of 76 patients (2,6%) had after therapy a persistent permanent strabismus.

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Artikel online veröffentlicht:
24. Mai 2022