View 2019 Abstracts

We report the outcomes of endonasal orbital decompression performed by oculoplastic surgeons experienced in endonasal techniques.

Retrospective case series of endoscopic orbital decompression across two hospital sites (Brighton [UK], Adelaide [Australia]) between January 2011 and July 2018 for 3 groups:
1) dysthyroid optic neuropathy
2) proptosis secondary to thyroid eye disease
3) proptosis secondary to other orbital conditions
Information collected include patient demographics, surgical details, pre- and post-operative clinical findings (visual acuity [VA], exophthalmometry readings, ocular motility, diplopia), and complications.

There were 87 cases of endoscopic decompression (Group 1–10, Group 2–70, Group 3–7). Group 3 conditions included 1 each of optic nerve sheath meningioma, sphenoid wing meningioma, idiopathic myositis, myopic large globe, osteo-odonto-keratoprosthesis lamina protrusion, Crouzon syndrome, and third nerve palsy. Most patients had endoscopic medial and posterior medial wall/floor decompression [38/70 (54%)].

VA improved in 3/10 and stabilized in 7/10 of Group 1. VA remained stable in 69/70 in Group 2 and 7/7 in Group 3. There was an average reduction in proptosis of 2.0 ± 1.6mm (standard deviation – SD) in Group 1, 4.6 ± 2.1mm (SD) in Group 2, and 3.5 ± 1.4mm (SD) in Group 3. Motility improved in 7/10 and remained stable in 3/10 in Group 1, improved in 8/70 and worsened in 2/70 in Group 2, and remained stable in 7/7 in Group 3. There were no new cases of post-operative diplopia. There were no significant complications.

Oculoplastic surgeons experienced in endonasal techniques can perform endoscopic orbital decompression with outcomes comparable to the literature.