Risk Factors for New Onset Diplopia After Graduated Orbital Decompression.


Journal

Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431

Informations de publication

Date de publication:
Historique:
pubmed: 16 2 2021
medline: 16 11 2021
entrez: 15 2 2021
Statut: ppublish

Résumé

The aim of the study was to identify possible risk factors for new onset diplopia in 20° of primary position (NOD PP) after orbital decompression. A predisposition for NOD has been established for patients with pre-existing diplopia in secondary gaze; therefore, the authors focused on patients without preoperative diplopia. Retrospective chart review of patients who underwent balanced orbital decompression between 2012 and 2019 due to Graves orbitopathy at the authors' institution. Exclusion criteria were incomplete clinical data set, revision surgery, and medial or lateral decompression only. The following clinical parameters were evaluated preoperatively and postoperatively: Hertel exophthalmometry, objective measurement of misalignment using the prism-cover-test, assessment of the field of binocular single vision, and measurement of monocular excursions. In addition, the diameter of the extraocular eye muscles was measured in all preoperative CT scans. We included 327 patients (612 orbits), 126 patients (242 orbits) had no preoperative diplopia. In patients with NOD PP (34%, n = 43/126), enlargement of the medial rectus muscle and restriction of abduction and elevation were significantly more frequent than in patients with no NOD PP. The degree of exophthalmos decrease positively correlated with postoperative squint angle. We were able to identify the diameter of the medial rectus muscle, restriction of abduction, and elevation as well as an extensive reduction of exophthalmos as risk factors for NOD PP in patients with no preoperative diplopia.

Identifiants

pubmed: 33587422
doi: 10.1097/IOP.0000000000001949
pii: 00002341-202111000-00009
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

564-570

Informations de copyright

Copyright © 2021 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Déclaration de conflit d'intérêts

The authors have no financial or conflicts of interest to disclose.

Références

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Auteurs

Kerstin Stähr (K)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

Anja Eckstein (A)

Department of Ophthalmology (Chair: Prof. Bechrakis), University Hospital Essen, Germany.

Maren Buschmeier (M)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

Timon Hussain (T)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

Anke Daser (A)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

Michael Oeverhaus (M)

Department of Ophthalmology (Chair: Prof. Bechrakis), University Hospital Essen, Germany.

Stephan Lang (S)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

Stefan Mattheis (S)

Department of Otorhinolaryngology, Head and Neck Surgery (Chair: Prof. Lang).

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