A randomized comparative study of inferomedial vs. balanced orbital decompression. Analysis of changes in orbital volume, eyelid parameters, and eyeball position

Background/objectives The objective of this study is to investigate and compare changes in orbital volume, eyelid parameters, and eyeball position after inferomedial and balanced (medial + deep lateral walls) orbital decompression (OD) in patients with Graves’ orbitopathy (GO). Subjects/methods Prospective interventional trial. Forty-two patients with inactive GO and clinical indication for OD were randomly assigned to inferomedial or balanced OD. Preoperative and postoperative Hertel exophthalmometry, standardized photography, and computed tomography were used to evaluate upper and lower eyelid margin reflex distances (MRD 1 and MRD 2 ), orbital expansion, and changes in eyeball position. Results Clinical and radiological exophthalmometry improved significantly after OD with both surgical techniques ( p