Endoscopic Orbital Decompression for Graves' Orbitopathy - A Vietnam Study

Purpose: To evaluate the efficacy and safety of endoscopic orbital decompression in patients with Graves' orbitopathy. Patients and Methods: This is a prospective study in Hanoi Medical University and a Military Hospital from December 2017 to December 2018. Twenty-eight orbits of fifteen patients were undergoing endoscopic orbital decompression for Graves' orbitopathy. Indications for surgery were proptosis in twenty-two orbits and compressive optic neuropathy in six orbits. The outcome measures were proptosis reduction, visual acuity, visual field test and diplopia. Post-operative complications including cerebrospinal fluid leakage, haemorrhage, lacrimal duct impairment, worsening diplopia, sinusitis and cellulitis were collected. Results: The mean proptosis reduction was 2.23 mm. Visual acuity and medium deviation in the Humphrey visual field were significantly improved in four of six eyes with compressive optic neuropathy. There was one patient with intra-operative excessive bleeding which resolved without affecting visual outcome. Post-operatively, two patients developed a new onset of diplopia and two others worsened diplopia; three have already undergone successful strabismus surgery and moderate proptosis reduction. Conclusion: Endoscopic orbital decompression surgery was effectively and safely to manage compressive optic neuropathy of Graves' orbitopathy and moderately reduce proptosis in a group of Vietnamese patients.