The importance of rim removal in deep lateral orbital wall decompression

Hirohiko Kakizaki1, Yasuhiro Takahashi1, Akihiro Ichinose2, Masayoshi Iwaki1, Dinesh Selva3, Igal Leibovitch41Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; 2Department of Plastic Surgery, Kobe University, Kobe, Hyogo, Japan; 3South Australian Institute of Ophthalmolo...

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Autores principales:	Kakizaki H, Takahashi Y, Ichinose A, Iwaki M, Selva D, Leibovitch I
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/e4c17a43c255433c9f6b2d94eab00aa5
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spelling	oai:doaj.org-article:e4c17a43c255433c9f6b2d94eab00aa52021-12-02T03:48:24ZThe importance of rim removal in deep lateral orbital wall decompression1177-54671177-5483https://doaj.org/article/e4c17a43c255433c9f6b2d94eab00aa52011-06-01T00:00:00Zhttp://www.dovepress.com/the-importance-of-rim-removal-in-deep-lateral-orbital-wall-decompressi-a7738https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Hirohiko Kakizaki1, Yasuhiro Takahashi1, Akihiro Ichinose2, Masayoshi Iwaki1, Dinesh Selva3, Igal Leibovitch41Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; 2Department of Plastic Surgery, Kobe University, Kobe, Hyogo, Japan; 3South Australian Institute of Ophthalmology and Discipline of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, Australia; 4Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, IsraelPurpose: To evaluate the surgical outcome of deep lateral orbital decompression with or without rim removal.Design: Retrospective case series.Methods: Thirty-two patients (47 orbits) with Graves&rsquo; orbitopathy who underwent simple deep lateral decompression or balanced lateral plus medial decompression. Of the 14 patients (24 orbits) who underwent simple deep lateral decompression, 8 (13 orbits) had temporary rim removal and in 6 (11 orbits) the rim was left intact. Of the 18 patients (23 orbits) who underwent a balanced decompression, 7 (9 orbits) had temporary rim removal and in 11 (14 orbits) the rim was left intact. The amount of postoperative reduction in proptosis was compared among these four groups.Results: The average reduction in proptosis in the simple deep lateral decompression group was 5.73 mm (range: 4.0&ndash;8.0 mm) in the rim removal group and 4.09 mm (range: 2.5&ndash;6.0 mm) in the intact rim group (P = 0.005). The average reduction in proptosis in the balanced decompression group was 6.39 mm (range: 5.0&ndash;8.5 mm) in the rim removal group and 5.07 mm (range: 3.0&ndash;8.0 mm) in the intact rim group (P = 0.039). There was no statistically significant difference in proptosis reduction between the simple deep lateral decompression with rim removal group and the balanced decompression with an intact rim group (P = 0.220).Conclusion: The rim removal approach allows a more effective decompression than the intact rim approach. Simple deep lateral decompression with rim removal approach has a similar effect to balanced decompression through an intact rim.Keywords: deep lateral decompression, balanced decompression, rim removal, intact rim, Graves&rsquo; orbitopathy, proptosisKakizaki HTakahashi YIchinose AIwaki MSelva DLeibovitch IDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2011, Iss default, Pp 865-869 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kakizaki H Takahashi Y Ichinose A Iwaki M Selva D Leibovitch I The importance of rim removal in deep lateral orbital wall decompression
description	Hirohiko Kakizaki1, Yasuhiro Takahashi1, Akihiro Ichinose2, Masayoshi Iwaki1, Dinesh Selva3, Igal Leibovitch41Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; 2Department of Plastic Surgery, Kobe University, Kobe, Hyogo, Japan; 3South Australian Institute of Ophthalmology and Discipline of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, Australia; 4Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, IsraelPurpose: To evaluate the surgical outcome of deep lateral orbital decompression with or without rim removal.Design: Retrospective case series.Methods: Thirty-two patients (47 orbits) with Graves&rsquo; orbitopathy who underwent simple deep lateral decompression or balanced lateral plus medial decompression. Of the 14 patients (24 orbits) who underwent simple deep lateral decompression, 8 (13 orbits) had temporary rim removal and in 6 (11 orbits) the rim was left intact. Of the 18 patients (23 orbits) who underwent a balanced decompression, 7 (9 orbits) had temporary rim removal and in 11 (14 orbits) the rim was left intact. The amount of postoperative reduction in proptosis was compared among these four groups.Results: The average reduction in proptosis in the simple deep lateral decompression group was 5.73 mm (range: 4.0&ndash;8.0 mm) in the rim removal group and 4.09 mm (range: 2.5&ndash;6.0 mm) in the intact rim group (P = 0.005). The average reduction in proptosis in the balanced decompression group was 6.39 mm (range: 5.0&ndash;8.5 mm) in the rim removal group and 5.07 mm (range: 3.0&ndash;8.0 mm) in the intact rim group (P = 0.039). There was no statistically significant difference in proptosis reduction between the simple deep lateral decompression with rim removal group and the balanced decompression with an intact rim group (P = 0.220).Conclusion: The rim removal approach allows a more effective decompression than the intact rim approach. Simple deep lateral decompression with rim removal approach has a similar effect to balanced decompression through an intact rim.Keywords: deep lateral decompression, balanced decompression, rim removal, intact rim, Graves&rsquo; orbitopathy, proptosis
format	article
author	Kakizaki H Takahashi Y Ichinose A Iwaki M Selva D Leibovitch I
author_facet	Kakizaki H Takahashi Y Ichinose A Iwaki M Selva D Leibovitch I
author_sort	Kakizaki H
title	The importance of rim removal in deep lateral orbital wall decompression
title_short	The importance of rim removal in deep lateral orbital wall decompression
title_full	The importance of rim removal in deep lateral orbital wall decompression
title_fullStr	The importance of rim removal in deep lateral orbital wall decompression
title_full_unstemmed	The importance of rim removal in deep lateral orbital wall decompression
title_sort	importance of rim removal in deep lateral orbital wall decompression
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/e4c17a43c255433c9f6b2d94eab00aa5
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The importance of rim removal in deep lateral orbital wall decompression

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