PubMed ID: 41082925
Author(s): Hong A, Shoji MK, Villatoro GA, Radha-Saseendrakumar B, Baxter SL, Dolman PJ, Kazim M, Harrison AR, Lucarelli MJ, Garrity JA, Selva D, Ediriwickrema LS, Liu CY, Korn BS, Kikkawa DO. Intersurgeon Variability in Proptosis Reduction After Orbital Decompression for Thyroid Eye Disease: A Multicenter Analysis. Ophthalmic Plast Reconstr Surg. 2025 Oct 13. doi: 10.1097/IOP.0000000000003090. Online ahead of print. PMID 41082925
Journal: Ophthalmic Plastic And Reconstructive Surgery, Oct 2025
PURPOSE This study assesses intersurgeon variability in proptosis reduction after orbital decompression for thyroid eye disease.
METHODS This multicenter retrospective study included patients with thyroid eye disease who underwent orbital decompression from 1 of 7 surgeons at 7 different institutions between January 2002 and December 2018. Data were included if a single decompression technique was performed on ≥10 patients by ≥2 surgeons. The primary outcome was postoperative change in proptosis with emphasis on comparison among surgeons utilizing similar surgical techniques. Statistical analysis was performed with χ2 and ANOVA testing, and a multivariable logistic regression model was generated.
RESULTS Six hundred thirty-three orbits that underwent orbital decompression were included. Five different decompression techniques were analyzed: medial wall (n = 29), fat + lateral wall (n = 113), medial wall + floor (n = 123), fat + lateral wall + medial wall (n = 140), and fat + lateral wall + medial wall + floor (n = 228), without significant difference in proptosis reduction among surgeons. Surgeons did not demonstrate significant differences in outcomes at different time points compared with each other or themselves. Outcomes when comparing endoscopic versus open medial wall decompression varied among surgery types. Multivariate modeling revealed a statistically significant association between postoperative change in proptosis with preoperative proptosis (p < 0.001).
CONCLUSIONS Postoperative change in proptosis did not differ significantly between surgeons utilizing similar orbital decompression techniques for patients with thyroid eye disease. This study may strengthen the statistical validity of multicenter clinical trials assessing orbital decompression outcomes performed by surgeons employing uniform surgical techniques, thereby advancing our understanding of optimal surgical management strategies for thyroid eye disease.
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