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January 1981

Transorbital Approach to Decompression in Graves' Disease

Author Affiliations

From the Oculoplastic Service, Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City. Dr Linberg is now in private practice in St Louis.

Arch Ophthalmol. 1981;99(1):120-124. doi:10.1001/archopht.1981.03930010122016

• Patients with Graves' disease have an increased volume of orbital tissue that sometimes results in serious functional and cosmetic problems. Visual loss may result from optic nerve compression in the orbital apex. Surgical decompression provides space for expansion of orbital tissues and often results in dramatic improvement. A transorbital approach to decompression of the orbit, appropriate for the ophthalmologist with adequate orbital experience, is presented. A lower eyelid incision is used in the manner of exploring a blow-out fracture. The majority of the orbital floor and the entire ethmoidal complex are removed. Removal of bone to the orbital apex is emphasized in cases of optic neuropathy. A comparative study of the indications, results, and complications of this procedure vs other techniques of decompression for Graves' disease is presented in a companion article.