Orbital decompression: For decreased visual acuity or for cosmetic reasons

Because the authors' results in patients with decrease of visual acuity treated with orbital decompression were so favourable they decided to start decompressing patients for cosmetic reasons only. A total number of 99 orbits were decompressed. Fifty-eight orbits were decompressed because of malignant Graves' ophthalmopathy, via the anterior (20 orbits), the anterolateral (14 orbits) and the coronal (14 orbits) approach. Fifty-one orbits of patients with Graves' ophthalmopathy were decompressed for cosmetic reasons, 22 orbits via the anterior approach, 29 were decompressed coronally. It appeared that even a decrease of preoperative motility impairment in 20% of patients was achieved. Interruption of pathological fibrotic strings and adhesions between orbital connective tissue and the periorbit probably explains these favourable results.