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Gershon Spector, MD, St Louis, and coworkers reviewed the charts of all 338 patients who underwent orbital decompression for dysthyroid exophthalmopathy at Washington University, St Louis, since 1948. The main objective of this surgical procedure is to restore vision, improve the movement of the extraocular muscles, and provide lid closure to protect the cornea. The patient is evaluated preoperatively with thyroid function tests and computed tomography in the axial plane with coronal reformatted images. An ophthalmologic evaluation is also obtained.
Long-term follow-up was available on 305 patients. The ages of the patients ranged from 16 to 80 years, with a three-to-one female predominance. The amount of recession achieved ranged from 1 to 12 mm. Visual acuity remained the same or was improved in all patients. A third of the patients were free of diplopia preoperatively and postoperatively, but 69 patients required additional muscle surgery following orbital decompression. Eight percent of