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Purpose : Orbital decompression is considered when the complications cause symptoms or signs of compressive optic neuropathy. After orbital decompression, not only the protrusion of the eye is reduced but also the shape and position of the eyelid changes. However, there is no study of the changes of the eyelid index when the medial orbital wall is operated alone and the medial and inferior orbital wall are operated simultaneously. In this study, we divided the patients into two groups: To evaluate whether there is any difference in the change of eyelid index.
Methods : From January 1, 2015 to December 31, 2017, 31 patients who underwent orbital decompression were retrospectively recruited. Before surgery, 3 months, 6 months, and 1 year after surgery, the front view photographs of the patient were taken. The eyelid index, presence of eyelid retraction, eyelid lag, lagophthalmos, and proptosis were measured.
Results : Of the 31 patients (61 eyes), Upper eyelid retraction was observed in 4 eyes and 12 eyes before surgery, 4 eyes and 5 eyes were observed one year later (p = 0.042), respectively. The eyelid lag was observed in 3 eyes and 18 eyes before surgery, and 1 eye and 2 eyes were observed one year later. (P = 0.30). Lagophthalmos were observed in 1 eye and 11 eyes before surgery, and 0 eyes and 2 eyes one year later (p = 0.64).
Conclusion : In previous studies, there was no significant improvement in the upper eyelid retraction postoperatively. However, when compared to the group with the medial orbital wall alone and the group with the medial and inferior orbital wall simultaneously, there was a statistically significant improvement in upper eyelid retraction. Therefore, when determining the orbital decompression in patients with upper eyelid retraction, the advantages and disadvantages of the surgical procedure should be fully considered.
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