What does it involve?
Thyroid orbitopathy causes the volume of the muscles and fat behind the eye to thicken and increase. Exophthalmos occurs, because the orbit is a rigid space and the muscles and fat move the eye forward in search of space. During this process, the eyelids and strabismus also retract. Orbital decompression surgery for exophthalmos involves opening up space in the orbit by means of creating windows in the bone. This provides the muscles and fat with more space and enables the eye to return to its correct position. Once the exophthalmos problem has been solved, any strabismus and eyelid retraction can be corrected.
When is it carried out?
Surgery is indicated for all exophthalmos cases, but, in cases where vision is seriously threatened by pressure in the orbit, it must be performed as soon as possible.
A comprehensive eye and eyelid examination, as well as a CAT scan of the orbits.
Before the surgery
Patients should not take anticoagulants or aspirin before surgery. It is essential for patients to stop smoking.
The procedure is performed under local anaesthesia and sedation or under general anaesthesia. It is possible to make a bilateral decompression in one single intervention.
Surgery always seeks to achieve symmetry between both eyes, but there is a risk of hyper or hypocorrection. After decompression, some eyelid malposition (retraction or ptosis) can occur, as well as double vision, which, in some cases, is temporary and, in others, not. Malposition and strabismus can be corrected later.