Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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A Modified Kroenlein Approach for Orbital Decompression in Grave's Ophthalmopathy: Indications, Technique, Results

Fichter N., Schittkowski M., Vick H.-P., Guthoff R.
Universitäts-Augenklinik Rostock

Purpose: In Grave's disease a discrepancy between volume increase of the orbital soft tissues and fixed volume of the orbital cavity leads to exophthalmos. The patients do not only feel cosmetically disfigured, they often complain about more or less painful retroorbital pressure sensation or show symptoms of corneal exposure because of a significant lid lag. To serve this problem, different orbital decompression techniques have been developed. This is to report about our results of orbital decompression by lateral approach.
Method: 27 patients (10 m, 17 f) aged 19 to 76 years (average 43,7 years) with Grave's ophthalmopathy were recorded who had undergone orbital decompression by a lateral approach between 1999 and 2003. 11 patients underwent bilateral decompression, so a total of 38 orbits were included in this follow-up study. The orbital decompression by a lateral approach in a modified Kroenlein-technique was obtained by the removement of a bony fragment of the lateral wall and an additional resection of retrobulbar fat. The preoperative data was evaluated retrospectively, while postoperative data was obtained by reexamination of the patients in our outpatient clinic. Beside the common ophthalmologic examination, special interest was put in: 1. reduction of exophthalmos, 2. reduction of retrobulbar pressure sensation, 3. lid signs, 4. motility changes.
Results: T

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