Results of Orbital Decompression Performed Primarily for Cosmetic Indication in Thyroid Orbitopathy

Purpose: Four-staged operation is currently the most effective treatment available in the management of stable thyroid orbitopathy. Many argue that decompression carries risks of operative complications such as binocular diplopia, and visual loss. So they are only warranted when there are compressive optic neuropathy or exposure keratopathy. This study reports detailed results of orbital decompression for 33 patients in whom the indications were primarily cosmetic. Methods: Between 1989 and 1998, 33 consecutive patients (62 orbits) with thyroid orbitopathy received orbital decompression for cosmetic indication. The medical records and photographs of these patients were reviewed. Results: The mean retroplacement was 4.81±1.72mm (range, 0 to 9mm). All 33 patients remained within 2mm of asymmetry postoperatively. The previously mentioned ”diplopia de novo” was not found in our series. There were no surgical complications except for infraorbital nerve hypoesthesia. Conclusion: Staged rehabilitation is effective in reducing exophthalmos and correcting the cosmetic sequelae of dysthyroid orbitopathy. Careful evaluation of clinical parameters and experienced surgeons are the keys to success.