Single-session orbital decompression, strabismus and eyelid surgery appears effective for thyroid eye disease

This retrospective, comparative, nonrandomized study assessed the outcomes of simultaneous orbital decompression, strabismus and/or eye surgery in patients with moderate to severe thyroid-associated orbitopathy.

Study design

The authors reviewed 45 patients who underwent treatment during a 7-year period. Twenty patients received decompression, eyelid and/or strabismus surgery in a single operative session (group 1). The remaining patients underwent staged decompression and either eyelid retraction repair (group 2) or strabismus surgery (group 3).

Outcomes

Patients who underwent single-session surgery showed similar improvements in eyelid position or diplopia as those who had staged procedures. A single patient in group 1 developed a complication (recurrent dysthyroid optic neuropathy). These results suggest that procedures may be combined into a single surgical experience, possibly resulting in significant cost savings, better patient satisfaction and decreased recovery time.

Limitations

The study’s nonrandomized and retrospective design may have introduced multiple biases. Additionally, the small sample size suggests that the results should be interpreted with caution. However, the idea is very promising and could revolutionize the approach to surgical rehabilitation of thyroid eye disease.

Clinical significance

This study demonstrates that a single operative experience may result in equal outcomes to staged procedures for thyroid eye disease. If these results can be confirmed in a prospective study, physicians could rapidly expedite surgical therapy for these patients.