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OBJECTIVE To identify factors that may help predict the outcome after transantral orbital decompression in Graves' ophthalmopathy. METHODS A retrospective study was conducted of 428 patients who had undergone an initial transantral orbital decompression for severe Graves' ophthalmopathy at the Mayo Clinic between November 1969 and May 1989. METHODS With use of logistic regression analysis, we assessed the preoperative characteristics, the early postoperative results, and the follow-up questionnaire data (obtained a median of 9.5 years postoperatively) from 304 female and 124 male patients with Graves' ophthalmopathy who had undergone transantral orbital decompression at a median age of 53 years. RESULTS On multivariate stepwise regression analysis, young age, male sex, and long duration of eye symptoms were predictors of severe initial proptosis (P < 0.001). The only independent predictors of greater postoperative recession of proptosis were severity of initial proptosis and longer interval between operation and postoperative examination (P < 0.001). Patients with the most reduction of proptosis had the greatest improvement in visual acuity but more chance for postoperative development of continuous diplopia. Failure of prior corticosteroid or orbital radiation therapy did not affect the degree of recession of proptosis or improvement in visual acuity. On multivariate analysis for predictors of long-term overall patient satisfaction, only young age of the patient was of borderline significance (P = 0.05), and the only significant predictor of satisfaction with the postoperative eye appearance was an operation done primarily for cosmetic purposes (P = 0.012). CONCLUSIONS Although various factors may influence the outcome of orbital decompression in patients with Graves' ophthalmopathy, this study showed that the more pronounced the initial proptosis, the greater the degree of recession postoperatively. A higher degree of reduction of proptosis is associated with better visual acuity but also a greater likelihood of development of continuous diplopia.
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
September 1988,
The British journal of ophthalmology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
December 2001,
Ophthalmology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
August 1994,
Clinical otolaryngology and allied sciences,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
January 1982,
Transactions of the New Orleans Academy of Ophthalmology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
April 2005,
Revue de stomatologie et de chirurgie maxillo-faciale,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
February 2001,
Ophthalmology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
January 2006,
Brazilian journal of otorhinolaryngology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
September 1985,
The Journal of laryngology and otology,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
November 1998,
The Laryngoscope,
V Fatourechi, and
E J Bergstralh, and
J A Garrity, and
G B Bartley, and
C W Beatty, and
K P Offord, and
C A Gorman
January 2005,
American journal of rhinology,
