Personalized orbital decompression surgery for thyroid-associated orbitopathy: a comprehensive retrospective analysis of efficacy, safety, and surgical strategy.
Combined medial-lateral wall decompression reduced proptosis by about 7.67 mm
Personalized orbital decompression surgery for thyroid-associated orbitopathy: a comprehensive retrospective analysis of efficacy, safety, and surgical strategy.
This study aimed to comprehensively evaluate the efficacy and safety of personalized multimodal orbital decompression for thyroid-associated orbitopathy (thyroid-associated orbitopathy) via large-scale retrospective analysis, and to optimize surgical strategies accordingly.
A retrospective cohort study included 199 thyroid-associated orbitopathy patients (263 eyes) who underwent orbital decompression between September 2021 and June 2025.
less bulging eyes after surgery - a bigger drop means more improvement
Overall mean proptosis was reduced from 21.16 ± 2.75 mm to 15.01 ± 1.86 mm (p < 0.0001).
Mean BCVA improved from 0.67 ± 0.68 LogMAR to 0.34 ± 0.42 LogMAR (p < 0.0001), with the most significant improvement seen in patients with preoperative Dysthyroid Optic Neuropathy (Dysthyroid Optic Neuropathy).
Dysthyroid Optic Neuropathy was present in 46.4% of eyes, with the highest prevalence in Groups 2 (76.6%) and 4 (62.2%).
Endoscopic medial wall decompression (Group 2) was associated with the lowest complication rate (4.3%).
In this large single-centre retrospective cohort, individualized orbital decompression was associated with significant improvements in proptosis, visual function, IOP, ocular motility, and diplopia-related outcomes in patients with thyroid-associated orbitopathy.
Combined medial-lateral wall decompression achieved greater proptosis reduction, whereas procedures involving medial wall decompression were associated with visual improvement in eyes with Dysthyroid Optic Neuropathy.