Trancaruncular Orbital Decompreion: An Alternate Procedure for Grave Ophthalmopathy With Compreive Optic Neuropathy Original Reearch Article

Purpoe To tudy the efficacy of trancaruncular orbital apex decompreion for Grave ophthalmopathy with compreive optic neuropathy nonreponive to pule corticoteroid. Deign Retropective, interventional cae erie tudy. Method From Augut 1999 to November 2003, trancaruncular orbital decompreion wa performed in 22 conecutive Grave ophthalmopathy patient with compreive optic neuropathy refractory to pule corticoteroid. The average period of corticoteroid treatment wa 16.1 ± 5.2 day. Main outcome meaure were preoperative and potoperative bet-corrected viion, Hertel exophthalmometry, 100-hue color enation tet, viual evoked potential, viual field, and new-onet diplopia. Reult Viual acuity improved ignificantly from 1.08 ± 0.24 logarithm of minimal angle of reolution (logMAR) preoperatively to 0.29 ± 0.18 logMAR potoperatively (P < .0001). Average improvement in retinal enitivity wa 9.4 ± 8.2 dB, in P100 value of viual evoked potential wa 27.5 ± 20.1, and in “total error” of the 100-hue tet wa 309.9 ± 214.3 after urgery. Average retroplacement effect wa 3.7 ± 1.6 mm. tatitical analyi howed ignificant difference between preoperative and potoperative meaurement for all above parameter (P < .0001). New-onet diplopia occurred in 38% of patient. There were no complication pecifically attributable to the trancaruncular technique. Concluion The trancaruncular approach offer acce to the medial and inferior wall for orbital apex decompreion in Grave ophthalmopathy patient with compreive optic neuropathy refractory to pule corticoteroid. Advantage over other approache included no external car, le damage to adjacent tiue, and wide expoure to the entire medial wall.