Biometric and refractive changes after orbital decompression in Korean patients with thyroid-associated orbitopathy

Abstract

Purpose To determine the biometric and refractive changes after orbital decompression in Korean patients with thyroid-associated orbitopathy (TAO). Methods Retrospective, observational study (between October 2012 and September 2014) was performed. Patients with TAO undergoing orbital decompression for stable proptosis received ophthalmic examinations, including Hertel exophthalmometry, A-scan biometry, autorefraction measures, corneal topography, and wavefront aberration measures, before orbital decompression and again 2 months after surgery. Results Included in the study were 43 eyes from 23 patients. The mean exophthalmometric value decreased by 4.1 mm 2 months after orbital decompression (Po0.001). On average, axial length (AL) increased significantly by 0.08 mm (Po0.001); specifically, 37 (86%) of the 43 eyes had increased AL. Whereas anterior chamber depth and lens thickness showed no significant changes (P = 0.086 and P = 0.905, respectively), the mean spherical refraction and spherical equivalent (SE) decreased by 0.35 and 0.48 D, respectively (P = 0.008 and Po0.001, respectively). However, cylindrical refraction and axis showed no significant changes (P = 0.057 and P = 0.218, respectively). The changes in AL and SE were significantly correlated (R = − 0.411, P = 0.009). Notably, there were no changes in corneal topography or wavefront aberration after orbital decompression. Conclusions TAO patients who underwent orbital decompression showed myopic refractive change via increase in AL. Possible refractive changes should be considered in cases of TAO complaining of decreased visual acuity after orbital decompression.

The Impact of Graves’ Ophthalmopathy on Anterior and Posterior Ocular Structures: Ocular Imaging Based Study

“…Another study reported that patients with GO who underwent orbital decompression showed myopic refractive change through increase in AL and they added possible refractive changes should be considered in cases of GO complaining of decreased visual acuity after orbital decompression. [11] The previous studies have reported that ocular blood flow was increased in patients with GO. Various techniques including Doppler imaging, ocular blood flow tonography, and oculo-dynamometry can ensure more reliable ocular blood flow measurements.…”

Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease

“…19 These findings were corroborated by Kim et al who found that axial length (AL) significantly increased after orbital decompression surgery (change in AL = 0.08mm p < 0.001). 20 We hypothesize that the fluctuating volume status of the orbit in TED is a reason for the increased risk of unexpected refractive prediction error in patients with TED. Although TED is thought to classically manifest with an active inflammatory phase, followed by a plateau and an inactive phase, there have been several reports in the literature that might suggest TED flares associated with cataract surgery.…”

“… 19 These findings were corroborated by Kim et al who found that axial length (AL) significantly increased after orbital decompression surgery (change in AL = 0.08mm p < 0.001). 20 …”

“Influence of Clinically Active Graves’ Ophthalmopathy on Spherical Equivalent and Visual Acuity”

“…The surgical treatment of severe GO known as orbital decompression reduces venous congestion and leads to a decrease in eyelid edema and chemosis, ultimately resulting in significant changes in the corneal curvature and refractive values. 24 …”