Treatment of Graves' Orbitopathy in 1990

Abstract

In summary, the first step in managing Graves' orbit-opathy rests with establishing a correct diagnosis. The evaluation does not stop at this point, however. A thorough ophthalmic examination to identify the patient's areas of concern and to evaluate the status of the visual acuity, eyelids, cornea, ocular motility and optic nerve is done. A general medical evaluation determines the status of the thyroid gland and any other medical problems which threaten the patient's health.
The surgical management of Graves' orbitopathy as described above at first glance might seem to be ag-gressive therapy. In many patients, especially those with severe or sight threatening orbitopathy, this type of therapy may prove to represent conservative therapy in the long-term as patients generally tend to be rehabi-litated sooner and can be spared untoward effects of prolonged high dose corticosteroids. It has been our belief that surgical management of severe orbitopathy is more predictable than medical management and that surgery is associated with an acceptable rate of compli-cations. While long-term follow-up has been provided for some patients treated by transantral orbital decom-pression, ³⁷ a larger group with longer follow-up is cur-rently being evaluated at our institution in order to further assess late results, detail any late complications, assess patient satisfaction and to review the status of thyroid function before and after decompression.