View 2019 Abstracts

To compare the management of postoperative pain after elective lateral wall orbital decompression (OD) with or without removal of the orbital rim in inactive thyroid eye disease (TED) patients

Retrospective case series included 14 TED patients (35.71% women [n = 5] and 64.29% men [n = 9]) who underwent elective lateral wall decompression recruited from James Cook Hospital (Middlesbrough) and Royal Victoria Infirmary Hospital (Newcastle). 7 patients had the orbital rim removed and sutured back and 7 had the orbital rim preserved during the procedure. Patients were asked about the medication taken at the first postop day. Standard treatment with paracetamol 1 gr QDS and ibuprofen 400 mg TDS was prescribed postoperatively and need for additional codeine 60 mg QDS was recorded

Only 1 patient who had the orbital rim removed (7.14%) complained of significant pain and required additional medication than the standard the following day to the operation. Patients who had their orbtial rim spared did not need supplimentary codeine or morphine. 3 patients with spared orbital rim (21.43%) and 3 who had it removed (21.43%) did not require ibuprofen and felt comfortable with the single use of paracetamol

According to our results, removal of the orbital rim is not a determining factor in predicting the degree of post operative pain after lateral wall OD. In addition, it increases the operative field and eases the room to manoeuvre in a narrow working space with a minor increase in the operative time. Consequently, orbital rim displacement can be considered comparable to lateral wall decompression with orbital rim preservation in terms of postoperative discomfort