To evaluate the long-term results of orbital fat decompression with or without lateral wall decompression in Grave's ophthalmopathy.

The authors studied retrospectively the 24 thyroid-related orbitopathy patients (32 eyes) who had undergone fat removal decompression or combined orbital decompression (lateral wall decompression with fat removal) based on average exophthalmometric values for Koreans. The patients were followed for over six months postoperatively, from December 2000 to December 2008.

The average amount of exophthalmos reduction was 4.13±2.60 mm in the fat removal decompression group and 5.79±2.02 mm in the combined orbital decompression group, respectively ( p <0.001). The final postoperative BCVA (best corrected visual acuity) in patients with compressive optic neuropathy improved in all cases. Intraocular pressure decreased significantly in all groups after operation ( p <0.001). Except for one patient who had newly onset diplopia, which was transient, no patient's diplopia worsened.

The authors obtained excellent surgical results in the treatment of orbital decompression and cosmesis without complications that can result from fat removal decompression or combined orbital decompression.