Comparison of results and quality of life in patients with thyroid eye disease after different methods of orbital decompression

Purpose. To evaluate the changes in the quality of life of patients with thyroid eye disease after different methods of orbital decompression. Materials and methods. The study included 24 patients (37 orbits) with thyroid eye disease, aged 41.6 ± 20.6 (from 20 to 79 years), 18 women and 6 men. The patients were divided into two groups. The first group included 12 patients (19 orbits) who underwent orbital fat decompression. The second group included 12 patients (18 orbits) who underwent endoscopic endonasal bony orbital decompression. The Graves’ ophthalmopathy quality of life questionnaire (GO-QOL) was completed before surgery, and 3 and 6 months after it. Outcome analysis included also the assessment of visual acuity, proptosis, eyelid retraction, and palpebral fissure height. Results. The GO-QOL visual function scores in both groups did not change significantly in 3 and in 6 months after orbital decompression ( p > 0.05): in the first group, before and after 6 months, scores were 69.27 ± 20.02 and 68.96 ± 18.44, in the second group – 53.13 ± 29.13 and 57.81 ± 23.56, respectively. An improvement in the GO-QOL visual function estimation was observed in those patients whose visual acuity improved after surgery. The GO-QOL facial appearance scores significantly improved 3 months after surgery, and continued to increase up to 6 months: in the first group, facial appearance scores improved from 23.96 ± 23.01 to 48.42 ± 25.56 ( p = 0.004), in the second group — from 47.92 ± 21.04 to 66.15 ± 23.15 ( p = 0.037). Conclusions. Orbital decompression significantly improves the quality of life of patients with thyroid eye disease, this is primarily associated with an improvement in facial appearance.