Severe Graves’ orbitopathy – analysis of therapeutic strategy in 23 patients
Journal Title: Journal of Stomatology (Czasopismo Stomatologiczne) - Year 2008, Vol 61, Issue 11
Abstract
Introduction: Graves’ disease is the autoimmunological thyroid disorder that leads to its hyperactivity. In addition to hyperthyroidism, over 25-50% of patients with Graves’ disease have a clinical involvement of eyes known as thyroid-associated orbitopathy. Aim of the study: To present strategy of surgical management as applied to 23 patients with severe Graves’ orbitopathy in whom previous pharmacological or combined treatments were unsuccessful. Material and methods: Between 1996-2007, 41 surgical orbital decompressions (18 bilateral and 5 unilateral ones) were performed in 23 patients at different clinical stages of severe Graves’ orbitopathy. Surgical technique consisted of two-wall orbital decompression followed by lipectomy and blepharoplasty.Results: Basing on ophthalmic examination 6 months after the surgery, reduction of proptosis ranging from 3 to 17 mm in all patients was observed. Diplopia found preoperatively in 14 of 23 patients, regressed fully in 8 cases. Reduction of diplopia was noted in 4, while in remaining 2 patients the problem persisted. Conclusion: There is no single effective method of therapy for severe Graves’ orbitopathy. The only treatment of choice for progressive loss of vision in patients resistant to corticosteroid and radiation therapy is surgical orbital decompression.
Authors and Affiliations
Hubert Wanyura, Helena Jastrzębska, Zygmunt Stopa
Keywords
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