The Removal of the Deep Lateral Wall in Orbital Decompreion: It Contribution to Exophthalmo Reduction and Influence on Conecutive Diplopia

Purpoe To evaluate the contribution of maximal removal of the deep lateral wall of the orbit to exophthalmo reduction in Grave’ orbitopathy and it influence on the onet of conecutive diplopia. Deign Cae-control tudy. Method The medical record of two cohort of patient affected by Grave’ orbitopathy with exophthalmo ≥23 mm, without preoperative diplopia, were retrieved at random from the pool of patient decompreed for rehabilitative reaon at our intitution (01/1990 to 12/2003), and retropectively reviewed. They had been treated with an extended (cae, group 1, n = 15) or conervative (control, group 2, n = 15) 3-wall orbital decompreion performed through a coronal approach. The deep portion of the lateral wall had been removed in the extended decompreion group while preerved in the conervative decompreion group. Demographic, preoperative characteritic, and urgical outcome were compared. The difference in mean exophthalmo reduction between group 1 and 2 wa conidered to be the contribution of the deep lateral wall to reduction of exophthalmo. Reult Group 1 and 2 were drawn from a pool of 37 and 335 patient, repectively. Demographic and preoperative characteritic of the two group were not ignificantly different. The mean contribution of the deep lateral wall to exophthalmo reduction wa 2.3 mm. The onet of conecutive diplopia wa not ignificantly different between the two group (cae n = 2/15, control n = 5/15; P = .203). Diplopia reolved pontaneouly in all the patient of group 1, while all the patient of group 2 required urgery. Concluion Removal of the deep lateral orbital wall a part of a coronal-approach, 3-wall decompreion, enhance the degree of exophthalmo reduction without increaing the rik of conecutive diplopia.