Rehabilitative Orbital Decompression for Graves' Orbitopathy: Risk Factors Influencing the New Onset of Diplopia in Primary Gaze, Outcome, and Patients' Satisfaction

Background: Patients with moderate to severe Graves' orbitopathy (GO) rather frequently require rehabilitative surgery after medical therapy. Diplopia is the most common side effect of orbital decompression (OD). The aim of this study was to evaluate the occurrence of postoperative diplopia in primary gaze after OD, and the influence of the surgical approach on this outcome. Moreover, we investigated the results in terms of proptosis reduction, and the long-term subjective satisfaction of patients treated with OD with regard to their appearance and ocular function. Methods: A retrospective evaluation of 247 patients with GO treated with medial and lateral decompression (MLD) or lateral decompression (LD) OD between January 2002 and December 2009 was performed. Results: The overall prevalence of postoperative diplopia in primary gaze was 55/247 (22.3%), with a statistically significant difference ( p