眼眶减压术治疗甲状腺功能障碍性视神经病变

甲状腺功能障碍性视神经病变(dysthyroid optic neuropathy,DON)是甲状腺相关眼病的严重并发症之一。DON由于多病因导致眶内容物增多、眶内压增高,如延误治疗会造成不可逆性视力丧失。及时行眼眶减压术降低眶内压、减弱疾病活动性是治疗DON抢救视力、改善眼突度等的关键。眼眶减压术包括眼眶眶壁去除减压术、眶内脂肪切除减压术等。近年术式有所改进,包括深外侧壁减压术、内外壁平衡减压术、三壁最大化眶减压术、微创硬膜外眼眶减压术、鼻内镜下不同入路眶壁减压术、计算机辅助减压术、多种术式联合减压等,以期得到更好的治疗效果。(国际眼科纵览,2020,44:431-437)

Orbital decompression surgery for treatment of dysthyroid optic neuropathy

Dysthyroid optic neuropathy (DON) is one of the serious complications of thyroid associated ophthalmopathy. Due to multiple etiologies,  the increase of orbital contents and intraorbital pressure will result in irreversible vision loss if treatment is delayed. Timely orbital decompression to reduce intraorbital pressure and reduce disease activity is the key to treat DON to rescue vision and improve ocular protrusion. Orbital decompression includes orbital wall decompression,  orbital fat removal of decompression  etc. In recent years,  surgical technique improvement,  including deep lateral wall decompression,  internal and external wall balanced decompression,  three-wall to maximize orbital decompression,  minimally invasive epidural orbital decompression,  orbital wall decompression with different approaches under nasal endoscope,  computer-assisted decompression, multiple surgical methods combined decompression  etc,  has been developed for getting better treatment effects.(Int Rev Ophthalmol,  2020,  44:  431-437)