Purpose: To evaluate reduction of proptosis by fatty decompression

Design: Descriptive study

Methods: 3 patients (1 man and 2 women) with Graves ophthalmopathy were treated with FROD via transforniceal approach on 5 orbits. Study was performed on patients hospitalized in Shastin Central Hospital between October 2010 and March 2011. All eyes had preexisting upper eyelid retraction, 1 patient had dioplopia prior to surgery and 2 other patients didn’t have diplopia. Patients were examined 1 week and 1 month after the surgery. Main examination tool was Hertel exophthalmometer to measure the level of proptosis before and after the surgery.

Results: 1 patient who had preexisting diplopia, it didn’t change postoperatively (35PD). Other 2 patients didn’t have dilopia before the surgery neither it developed afterwards. All patients had upper eyelid retraction and 1 patient had lower lid retraction. The level of retraction wasn’t affected by surgery. In patient 1 Hertel value was 17 and 24 mm before the surgery, 6ml of fat was removed, Hertel value on left eye after the surgery became 18 mm. Patient 2 had 23 and 24 mm of Hertel value before the surgery, during the surgery 4ml of fat was removed from each orbit. Hertel value after the surgery became 19 and 20 mm. Patient 3 had Hertel values of 23 mm on both eyes; 4.5ml of fat was removed from each orbit. After the surgery Hertel value became 19 mm on both eyes. All patients didn’t experience hemorrhage as well as signs of damage to optic nerve and to other cranial or sensory nerve.

Conclusion: According to our study with fatty decompression it is possible to achieve good proptosis reduction without development of postoperative diplopia. The surgery technically is not difficult to perform.