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Goldberg et al1 (hereafter, the authors) present us with a new paradigm for orbital decompression in Graves ophthalmopathy. The decompression is a bony excision laterally but concentrated in 3 areas: the lacrimal keyhole, the orbital door jamb, and the basin of the inferior orbital fissure. It is a composite of "old wine together with new wine," and therein lies the reason for my letter. I will analyze the bony aspects (the "old wine") first.
Frankel J. Old Wine and New Wine. Arch Ophthalmol. 2000;118(7):1006-1007. doi: