Results of transantral orbital decompression in patients with thyroid-associated ophthalmopathy

Purpose: To present the results of orbital decompression in patients with t hyroid-associated ophthalmopathy (TAO), Methods: Transantral orbital decompression was performed in 63 patients wit h TAO. In 40 patients (63%) the operation was made because of progressive o phthalmopathy not responding to medical therapy, and in 23 patients (37%) t he operation was made for rehabilitative reasons, The long-term hypesthesia engaging the infraorbital nerve was assessed with a questionnaire using a Visual Analogue Scale (VAS), Results: The mean proptosis reduction was 3.2 mm (range 0-8 mm), Twenty-one patients had impaired visual acuity preoperatively, and 20 improved. Altog ether 30 patients (40%) had worsened ocular motility postoperatively, Forty -three patients did not have diplopia in the primary position preoperativel y, and new diplopia developed in 22 of these (51%). Hypesthesia in the infr aorbital nerve area was reported for half of the operated sides, but was a major cause of distress (VAS-scoring >5) to eleven patients, Conclusions: Transantral orbital decompression is indicated in patients wit h progressive TAO or in patients with prominent exophthalmos, and results i n a good proptosis reduction, but the risk of postoperative diplopia is sig nificant. Postoperative hypesthesia is common but often not a major problem .