Incidence and treatment of diplopia after three-wall orbital decompreion in Graveʹ ophthalmopathy

The author reviewed their experience in treating diplopia after orbital decompreion in patient with thyroid orbitopathy. Orbital decompreion wa performed on 102 patient (34 men and 68 women) for either compreive optic neuropathy or difiguring proptoi. Peritent potoperative diplopia in primary gaze wa preent in 53 eye (52%) ix month after orbital decompreion. Ten patient (9.8%) with no preoperative diplopia developed diplopia in primary gaze after decompreion. Among 43 patient with preoperative diplopia in primary gaze, 19 (18.6%) remained unchanged and 24 (23.5%) worened coniderably after decompreion. Nine (17%) of 53 patient with potoperative diplopia obtained reolution of potoperative diplopia with primatic lene. The remaining 44 patient (83%) underwent adjutable extraocular mucle urgery with the ue of vicoelatic ubtance to gain ingle viion in primary poition. Thirty-one of thee patient obtained table reolution of diplopia in primary gaze after one urgical procedure. Ten of thee patient required a econd urgery on the oblique mucle ix month after the firt procedure to eliminate peritent torional diplopia. Three of thee patient required primatic lene for full reolution of diplopia after trabimu urgery. Orbital decompreion of Graveʹ orbitopathy i aociated with a high incidence of potoperative diplopia that can ubequently be uccefully managed with trabimu urgery and primatic lene.—Michael D. Wagoner