gms | German Medical Science

Introduction: The main indications for orbital decompression concern acute reduction of visual acuity, severe restriction of visual field, restriction of ocular motility, diplopia and exophthalmus.

These symptoms are mostly caused by complications of inflammatory processes, traumas or tumors within the sinuses infiltrating and compressing the orbital structures – as well as to severe cases of endocrine orbitopathy.

For decompression surgery specific techniques are recommended - especially different external approaches and functional endoscopic surgery.

Results: Our clinical findings demonstrate the best results concerning visual loss in the treatment of inflammatory diseases. In 102 cases 1 preoperative blindness resisted surgical intervention, but preoperativ visual loss of 42 patients increased in 90% (n=38), 40% (n=17) reached visual acuity of 1 and better, 10% (n=4) decreased about 10–30% (not less than 0.5) of their preoperative level.

The prognosis of tumors was correlated to the histological findings. 53 malignant and 53 benign tumors were analyzed.

In 80 traumas combined with mostly severe visual loss. Orbital and optic nerve decompression surgery improved the visual acuity in 62.2% (25 of 41 amaurotic eyes achieved increase in vision (some up to visus 0.8).

The results of 27 eyes with compressive endocrine orbitopathy a modified technique of orbital 3-wall decompression showed improvement of visual function at an average of 4.63 ± 4.5 lines. Exophthalmus reduction was 3.2 ± 2.4 mm in the functional group and 3.9 ± 17 mm in the rehabilitation group.

Conclusion: Orbital complications of various pathogenesis are treated best by an interdisciplinary team. For different diseases producing orbital compression with indicated symptoms a lot of special surgical techniques are available. In our opinion successful treatment is closely correlated to optimal intraoperativen exposure and a clear concept for decompression surgery.