TRANSFRONTAL ORBITAL DECOMPRESSION AFTER FAILURE OF TRANSANTRAL DECOMPRESSION IN OPTIC NEUROPATHY OF GRAVES-DISEASE

Transantral and transfrontal orbital decompression procedures are effe ctive for treating optic neuropathy of Graves' disease. We studied 10 patients with Graves' disease to clarify whether transfrontal decompre ssion is effective after prior failure of transantral orbital decompre ssion. All patients had persistent or recurrent optic neuropathy after transantral decompression and had failed to respond to systemic corti costeroid therapy. After transfrontal decompression, visual acuity imp roved in 70% of the eyes, and visual field scotomas decreased in 80%. No major intraoperative or postoperative complications occurred. We co nclude that in optic neuropathy of Graves' disease, transfrontal orbit al decompression after failure of transantral decompression is an acce ptable and beneficial salvage procedure.