Endocrine orbitopathy (EO) can have important consequences, such as
exophthalmos and restrictive
strabismus. A retrospective study was performed of 35 patients with EO who underwent orbital
decompression surgery and restrictive
strabismus correction. Two surgical techniques for orbital
decompression were analyzed: fat
decompression by Olivari technique and three-wall bony expansion with fat
decompression.
Strabismus surgery was performed using adjustable or non-adjustable
sutures under topical anaesthesia. Patients were divided into two groups according to the type of intra-orbital
decompression performed, and the postoperative values resulting from the different fat
decompression techniques were recorded. The preoperative and postoperative mean degrees of
exophthalmos were 22.3 and 19.9mm, respectively, for the fat
decompression group, and 24.3 and 19.8mm, respectively, for the bony expansion with transpalpebral fat
decompression (combined form) group. The difference in residual prism dioptres between adjustable and non-adjustable
suture techniques in patients who had previously undergone combined
decompression was statistically significant. The management of patients with EO requires a multidisciplinary approach based on the collaboration of maxillofacial surgeons, ophthalmologists, and orthoptists. These results will allow the development of a more adequate strategy for the surgical treatment of restrictive
strabismus in EO patients.