What are the surgical options for the treatment of Graves ophthalmopathy?

Updated: Mar 23, 2018
  • Author: Sai-Ching Jim Yeung, MD, PhD, FACP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Ophthalmopathy is as follows:

  • Near-total thyroidectomy has little, if any, effect on the course of ophthalmopathy.

  • If ophthalmopathy is severe but inactive, orbital decompression may be performed. Reducing proptosis and decompressing the optic nerve can be achieved by transantral orbital decompression. A study by Alsuhaibani et al found that the change in the volume of the medial rectus muscle may help explain the variability in the proptosis reduction following orbital decompression. [82]

  • The major adverse effect is postoperative diplopia, which may necessitate a second surgery on the extraocular muscles to correct the problem.

  • Rehabilitative (extraocular muscle or eyelid) surgery is often needed. Eyelid surgery (eg, severance of the Müller muscle, scleral or palatal graft insertion) can be performed to improve exposure keratitis.


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