Reult and Predictability of Fat-Removal Orbital Decompreion for Difiguring Grave Exophthalmo in an Aian Patient Population Original Reearch Article

Purpoe To evaluate proptoi reduction by fat-removal orbital decompreion (FROD), to determine the incidence of potoperative diplopia, and to ae predictability of proptoi reduction per volume of reected orbital fat. Deign Cro-ectional tudy. Method One hundred and twenty patient (31 men; 89 women) with Grave ophthalmopathy were treated with FROD via the tranforniceal approach on 222 orbit between April 2003 and April 2006. Fifteen (12.5%) patient exhibited preoperative diplopia; 105 (87.5%) were without diplopia; mean follow-up ± tandard deviation (D) wa 10.9 ± 5.1 month (range, ix to 37 month). Univariate and multivariate analye were ued to evaluate Hertel change with FROD by linear regreion. The etting wa thyroid eye dieae pecial clinic at National Taiwan Univerity Hopital. Reult Mean Hertel value ± D decreaed from 20.3 ± 1.8 mm (range, 16.5 to 26.0 mm) to 16.8 ± 1.4 mm (range, 13.5 to 21.0). Mean proptoi reduction ± D wa 3.6 ± 1.0 mm (range, 1.5 to 7.5 mm). Mean volume of reected orbital fat ± D wa 3.6 ± 1.0 ml (range, 1.2 to 6.5 ml). New-onet diplopia wa noted for 2.8% of patient after FROD. The final predictive equation for Hertel change i hown a: 0.72 × removal of intraconal fat (ml) − 0.001 × age (yr) − 0.22 × gender (male, 1; female, 0) − 0.19 × preoperative diplopia (ye, 1; no, 0) + 1.02. Concluion FROD can achieve reaonable proptoi reduction and can reduce incidence of new-onet diplopia for patient with difiguring Grave exophthalmo. The volume of reected orbital fat correlate with mean Hertel value change. The amount of reected orbital fat may predict proptoi reduction.