Optic neuropathy of Graves disease: Results of transantral orbital decompression and long-term follow-up in 215 patients

.PURPOSE: To review demographic characteristics, clin, ical features, and long-term outcomes of patients with optic neuropathy of Graves disease after transantral orbital decompression. . DESIGN: Retrospective analysis of noncomparative in, terventional case series; long,term follow,up by questionnaire. . METHODS: Medical record data (preoperative and post, operative assessments) were collected from patients who had transantral orbital decompression to treat Graves optic neuropathy. Responses to two follow-up questionnaires concerning patient satisfaction were evaluated. Statistical analysis (reflected as P values) compared preoperative and early postoperative (:5182 days) data. .RESULTS: Between November 1969 and May 1989, 215 patients underwent transantral orbital decompression for Graves optic neuropathy. In 205 eyes with visual acuity of 20/40 or worse before decompression, visual acuity improved by 3 Snellen lines or more in 110 (54%) (P < .001). Of 291 eyes with visual field defects preoperatively, 120 (41%) had resolution, and 126 (43%) had improvement postoperatively (P < .001). Proptosis was reduced in 350 eyes by 4.4 +/- 2.3 mm (mean SD) (P < .001). In 104 eyes, disk edema resolved in 72 (69%) and improved in 28 (27%). Responses to questionnaires mailed in 1990 and 2000 showed that 76% and 88% of respondents, respectively, were subjectively satisfied with the results of orbital decompression. CONCLUSIONS: Transantral orbital decompression ap, peared to be effective in treating optic neuropathy of Graves disease. Patient satisfaction was high at 10-year and 20-year follow-up. (C) 2003 by Elsevier Inc. All rights reserved.