Three-dimensional changes of scleral show after surgical treatment of endocrine orbitopathy

Abstract Purpose Surgery in endocrine orbitopathy should address exophthalmos and adjunct stigmata such as increased lid aperture and scleral show. Secondary to decompression, rehabilitative surgical treatment such as blepharoplasty is routinely used to achieve this goal. Until now, however, there has been no investigation to measure the effect of decompression surgery on scleral show and lid aperture 3-dimensionally. Materials and methods Ocular surface area (OSA) and lid aperture of 34 patients (67 orbits) were measured pre and post decompression surgery in a retrospective investigation using 3-dimensional (3D) stereophotogrammetry. The mean follow-up after decompression was 6 ± 4 months. Results Mean OSA ranged between 3.1 ± 1.5 cm 2 (pre orbital decompression) and 2.5 ± 0.6 cm 2 (post orbital decompression). Orbital decompression caused a statistically significant reduction of the surface area of about 19.4% (p  Conclusion Our results show that surgical decompression, besides correcting exophthalmos, leads to a significant reduction of scleral show and lid aperture. However, it is not possible to estimate its effect on an individual basis.