Risk Factors Associated with Post-operative Squint after Decompression Surgery for Graves Ophthalmopathy
Pitz S.1, Eha J.1, Krummenauer F.2, Mann W.3, Kahaly G.4
1Augenklinik, 2Institut für Medizinische Biometrie, Epidemiologie und Informatik, 3Hals- Nasen-Ohrenklinik, 4Klinik für Innere Medizin mit Schwerpunkt Endokrinologie und Stoffwechselerkrankungen der Johannes Gutenberg-Universität, Mainz
Purpose: Post-operative squint is a major complication after decompression surgery for graves ophthalmopathy. It has severe implications for the every day life of the affected patients, as it may prevent activities such as driving car or working. Therefore, we were interested in identifying factors allowing an assessment of this risk in our patients.
Method: 57 patients underwent a simultaneous transethmoidal removal of the medial orbital wall as well as a transpalpebral removal of orbital fat. All of them had their eyes aligned prior to decompression surgery. They were investigated according to a standardized protocol prior to, 3 to 6 months after decompression surgery as well as prior to an eventual squint surgery.
Results: 22/57 patients developed post-operative misalignment necessitating squint surgery. These had in a significantly higher percentage already exhibited a motility impairment (<35° monocular duction) prior to decompression (82%vs. 46%; p=0.005). Surgically induced motility impairment was more pronounced in patients with lesser pre-operative restriction.
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