Fat-removal orbital decompression for disfiguring proptosis associated with Graves' ophthalmopathy: safety, efficacy and predictability of outcomes.

The objective of this study was to analyse clinical outcomes of patient who underwent fat-removal orbital decompression (FROD) for disfiguring proptosis associated with Graves' ophthalmopathy. This is a retrospective review of 21 eyes of 11 patients who have received transforniceal FROD for disfiguring Graves' exophthalmos at the Hong Kong Eye Hospital from January 2009 to March 2012. The amount of orbital fat removed and proptosis reduction in terms of Hertel value and complications were evaluated. The mean volume of orbital fat removed was 4.0 ± 1.1 ml (range 1.6-5.5 ml), and the mean change of Hertel value was 4.2 ± 1.3 (range 1-6, p < 0.000). None has visual loss or new-onset diplopia at primary gaze after FROD. No complications such as retrobulbar haemorrhage, meningitis, sinusitis, tissue necrosis, infraorbital paraesthesia or unsightly scar were observed. FROD could achieve reasonable proptosis reduction. It had a good safety profile, and results were predictable.