Study On The Effect Of Deep Medial Orbital Decompression Surgery On Dysthyroid Optic Neuropathy

Objective: To investigate the clinical effect of deep medial orbital decompression surgery in the treatment of dysthyroid optic neuropathy(DON).Methods: This study included 20 eyes(14 cases)of DON patients who met the inclusion and exclusion criteria from September 2018 to December 2020 in the Department of Ophthalmology,Affiliated Hospital of Northwest Minzu University.A historical controlled study design was adopted.According to the differences between the old and new surgical methods,10 eyes of DON patients treated with orbital balanced decompression surgery(old therapy)from September 2018 to October 2019 were selected as the control group,10 eyes of DON patients treated with deep medial orbital decompression surgery(new therapy)from November 2019 to December 2020 were selected as the experimental group.Both groups received the same symptomatic drug treatment.The postoperative follow-up observation was conducted for 1 week to 6 months.The visual acuity and exophthalmos of the two groups before and after treatment were compared by two-factor repeated measurement and two-level analysis of variance,and the postoperative complications and treatment,postoperative visual acuity follow-up were analyzed and compared.Results: The difference in visual acuity before and after treatment was statistically significant in both the experimental group(deep medial orbital decompression surgery)and the control group(orbital balanced decompression surgery)(F=7.142,P=0.016),visual acuity after treatment improved by 0.15 and 0.09 in the experimental and control groups,respectively;the difference in visual acuity improvement between the experimental group(deep medial orbital decompression surgery)and the control group(orbital balanced decompression surgery)was not statistically significant(F=0.159,P=0.694);the interaction between the groups* before and after treatment(F=0.469,P=0.502),there was no difference in visual acuity improvement between the two groups;the improvement trend of visual acuity in the experimental group was higher than that in the control group,but there was no statistical significance.The decrease in exophthalmos was statistically significant in both the experimental group(deep medial orbital decompression surgery)and the control group(orbital balanced decompression surgery)before and after treatment(F=355.018,P<0.001),and the exophthalmos after treatment decreased by 4.4 mm and 5 mm in the experimental and control groups,respectively;the difference between the decrease in exophthalmos in the experimental group(deep medial orbital decompression surgery)and the control group(orbital balanced decompression surgery)was not statistically significant(F=0.000,P=1.000);there was no difference in the decrease of exophthalmos between the two groups when comparing the interaction between the groups* before and after treatment(F=1.446,P=0.245).Conclusion: 1.Both deep medial orbital decompression surgery and orbital balanced decompression surgery can effectively expand the intraorbital volume and relieve the compression of the optic nerve,thus effectively improve the visual acuity and reduce the exophthalmos in patients with DON.2.There was no significant difference in the treatment effect between deep medial orbital decompression surgery and orbital balanced decompression surgery in patients with DON.