Our Summary

This research paper is about a study done on 35 patients who have Endocrine Orbitopathy (EO), a condition that can cause bulging of the eyes and abnormal eye movement. These patients were treated with surgery to relieve pressure in the eye socket and correct the abnormal eye movement.

The study looked at two different surgical methods used to reduce the pressure in the eye socket: one method removed some of the fat in the socket, and the other method expanded the socket by removing some of the bone and fat. The surgery to correct the abnormal eye movement was done using two different types of stitches, one adjustable and one not.

The results showed that the surgery reduced the bulging of the eyes in both groups. However, the difference in the remaining eye misalignment after surgery was significant between the group that had the combined bone and fat removal surgery and used adjustable stitches, as compared to non-adjustable stitches.

This suggests that the choice of surgical method and type of stitch can affect the results of the treatment for EO. The study emphasizes the need for a team approach involving different specialists to manage the treatment of patients with EO, and that these results can help in planning more effective surgical treatment strategies for this condition in the future.

FAQs

  1. What is endocrine orbitopathy and how does it relate to strabismus?
  2. What are the different surgical techniques used for orbital decompression in patients with EO?
  3. How is strabismus surgery performed and what role do adjustable and non-adjustable sutures play in it?

Doctor’s Tip

A helpful tip a doctor might tell a patient about strabismus surgery is to follow post-operative instructions carefully, including keeping the eyes clean and avoiding strenuous activities that could strain the eyes. It is also important to attend follow-up appointments to monitor progress and ensure proper healing. Additionally, patients should communicate any concerns or changes in vision to their doctor promptly.

Suitable For

Patients with endocrine orbitopathy (EO) who have exophthalmos and restrictive strabismus are typically recommended for strabismus surgery. In this study, patients with EO underwent orbital decompression surgery and restrictive strabismus correction. The study found that both fat decompression and bony expansion with fat decompression techniques were effective in reducing exophthalmos in patients with EO. Strabismus surgery using adjustable or non-adjustable sutures was also successful in correcting restrictive strabismus in these patients. The results suggest that a multidisciplinary approach involving maxillofacial surgeons, ophthalmologists, and orthoptists is important for the management of EO patients. These findings will help in developing better strategies for the surgical treatment of restrictive strabismus in patients with EO.

Timeline

Before strabismus surgery:

  • Patient is diagnosed with endocrine orbitopathy (EO) and experiences symptoms such as exophthalmos and restrictive strabismus.
  • Patient undergoes evaluation by a multidisciplinary team including maxillofacial surgeons, ophthalmologists, and orthoptists.
  • Surgical options for orbital decompression are discussed, including fat decompression by Olivari technique and three-wall bony expansion with fat decompression.
  • Patient chooses a surgical technique and undergoes orbital decompression surgery.
  • Patient is scheduled for strabismus surgery using adjustable or non-adjustable sutures under topical anaesthesia.

After strabismus surgery:

  • Patient undergoes strabismus surgery to correct restrictive strabismus, with the goal of improving ocular alignment.
  • Postoperative follow-up appointments are scheduled to monitor the patient’s progress and assess the outcome of the surgery.
  • The patient’s exophthalmos and degree of strabismus are measured before and after surgery to evaluate the effectiveness of the treatment.
  • Results of the surgery are recorded, including any residual prism dioptres and any differences between adjustable and non-adjustable suture techniques.
  • The patient may require further adjustments or additional treatment to achieve optimal results.

What to Ask Your Doctor

  1. What are the risks and potential complications of strabismus surgery for my specific case of endocrine orbitopathy?
  2. What is the success rate of strabismus surgery in patients with endocrine orbitopathy?
  3. Will I need any additional surgeries or treatments following strabismus surgery?
  4. How long is the recovery period after strabismus surgery, and what can I expect during the recovery process?
  5. Are there any specific post-operative care instructions I should follow to ensure the best outcome?
  6. How will strabismus surgery impact my overall visual function and quality of life?
  7. Are there alternative treatment options for my endocrine orbitopathy-related strabismus that I should consider before opting for surgery?
  8. Will I need to undergo any additional pre-operative tests or evaluations before scheduling strabismus surgery?
  9. How experienced are you in performing strabismus surgery for patients with endocrine orbitopathy?
  10. Can you provide me with any patient testimonials or success stories related to strabismus surgery in patients with similar conditions to mine?

Reference

Authors: Imburgia A, Elia G, Franco F, Perri P, Franco E, Galiè M, Clauser LC. Journal: Int J Oral Maxillofac Surg. 2016 Jun;45(6):743-9. doi: 10.1016/j.ijom.2015.12.002. Epub 2016 Jan 6. PMID: 26775634