ArticleIndian journal of ophthalmology2026
Efficacy and safety of secondary infero-medial orbital wall decompression after orbital fat decompression in Graves' orbitopathy: A 12-year experience.
Article in Indian journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the efficacy of secondary bony decompression following primary fat decompression.
designRetrospective interventional case series.
methodsSetting: A tertiary university hospital. STUDY POPULATION: A total of 27 eyes from 17 patients who underwent secondary inferomedial orbital wall decompression following primary orbital fat decompression were included. Patients with a history of trauma, extraocular muscle surgery, prior orbital irradiation, or eyelid or orbital inflammation within 6 months prior to decompression were excluded. INTERVENTION PROCEDURE: Secondary inferomedial orbital wall decompression performed for recurrent proptosis or compressive optic neuropathy after primary fat decompression.
main outcome measureChanges in Hertel value, and best corrected visual acuity (BCVA).
resultsPrimary orbital fat decompression achieved an initial proptosis reduction of 3.4 ± 0.1 mm in 27 eyes. Secondary bony decompression was subsequently performed in 15 eyes from 9 patients with recurrent proptosis and in 12 eyes from 8 patients with dysthyroid optic neuropathy. Secondary bony decompression resulted in a reduction in Hertel measurement by 4.5 ± 2.1 mm, improving from 21.7 ± 2.8 mm to 17.3 ± 1.6 mm ( P < 0.001) at a follow-up period of 40.6 ± 28.7 months. BCVA in patients with dysthyroid optic neuropathy improved from 0.43 ± 0.3 to 0.12 ± 0.15 logMAR ( P = 0.005). Diplopia occurred in 12 of 17 patients (70%), including five with new-onset diplopia. Preoperative diplopia predicted postoperative diplopia in regression analysis.
conclusionSecondary inferomedial orbital wall decompression following primary orbital fat decompression effectively reduces proptosis and improves vision.
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