Orbital Decompression Surgery

Thyroid associated orbitopathy (TAO) is an lymphocytic orbital inflammation that usually occurs in patients with autoimmune thyrotoxicosis (Graves’ disease), but can also occur both in hypothyroid and euthyroid patients. The goal of surgical treatment is to expand the bony confines of the orbit or to reduce orbital fat volume in order to retroplace the globe and accommodate pathologically enlarged muscles and fat. The literature describing various techniques for decompression is extensive, but there is no consensus on the optimum approach for given degrees of proptosis and TAO phenotypes. The purpose of this chapter is to present a practical approach to decompression of the orbit in patients with TAO, with special reference to surgical technique.