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목적 : To report eyeball position changes after orbital decompression in Korean patients with Graves’ orbitopathy (GO).
방법 : Medical records of 111 patients who underwent orbital decompression were retrospectively reviewed. Fifty-nine patients without restrictive myopathy and who underwent the same procedure on both eyes were included. Patients were divided into the following 3 groups by procedure: only fat decompression (group 1, n = 18 patients), fat and medial wall decompression (group 2, n = 11 patients), and fat, medial, and inferior wall decompression (group 3, n = 30 patients). Preoperative and postoperative proptosis and pupillary distance (PD) using photographs were measured.
결과 : Proptosis improved by 3.5 ± 1.2 mm in group 1 (P < 0.001), 3.5 ± 1.4 mm in group 2 (P<0.001), and 4.6 ± 1.3 mm in group 3 (P < 0.001). The PD shortened by 2.9 ± 2.4 mm in group 1 (P<0.001), 2.4 ± 1.3 mm in group 2 (P < 0.001), and 3.5 ± 2.4 mm in group 3 (P < 0.001). The differences between groups were not significant. The change in PD was significantly correlated with the level of proptosis reduction (r = 0.374, P = 0.003).
결론 : The PD shortened after orbital decompression in patients with fat proliferative GO. The change in PD was not related to the type of orbital decompression, but to the level of proptosis reduction. Medial shifting of the eyeball after decompression was primarily caused by a divergent orbital cone structure and not orbital tissue herniation into the ethmoid sinus.
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