AT A BASIC LEVEL, orbital decompression surgery, as compared with a field like, say, molecular biology, has advanced very little in the past 100 years. It still represents a lot of hammering and chiseling on a disease that would be better treated immunologically. To the credit of orbit surgeons, however, advancement of the field has not been stationary. A number of philosophical and technical advances have coalesced to evolve the surgical management of thyroid-related orbitopathy. I know that I personally have a substantially different approach to the surgical management of my own patients than I did 10 years ago. I will focus on 3 areas in which significant changes have occurred: the indications for orbital decompression, the bony surfaces that are selected for removal, and the incisions that are used to gain access to the orbital cavity.
Goldberg RA. The Evolving Paradigm of Orbital Decompression Surgery. Arch Ophthalmol. 1998;116(1):95–96. doi:10.1001/archopht.116.1.95
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