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Surgical Management of Thyroid Eye Disease

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

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Abstract

Surgical management of thyroid eye disease (TED) has two general aims: (1) relieve symptoms of orbital congestion and fibrosis, including possibly compressive optic neuropathy, and (2) reconstruct the periocular region to reduce deformity and renormalize appearance. Surgical management follows a sequence that is tailored to individual patient needs. The signs and symptoms of TED that can be addressed surgically include proptosis, orbital pressure/pain, orbital inflammatory signs, diplopia secondary to restrictive strabismus, ocular surface exposure secondary to lagophthalmos, and eyelid retraction. Because orbital decompression surgery can improve lagophthalmos and eyelid retraction, and can affect strabismus (positively or negatively), these issues are traditionally addressed sequentially by orbital decompression first, followed by strabismus surgery, and finally eyelid retraction repair, as needed. In this chapter, we focus primarily on orbital decompression surgery and eyelid surgery, although key aspects of strabismus surgery are also discussed.

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Authors and Affiliations

  1. Consultants in Ophthalmic and Facial Plastic Surgery, Southfield, MI, USA

    Anaïs L. Carniciu MD & Alon Kahana MD PhD

  2. Ophthalmic Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Department of Ophthalmology and Visual Science, Columbus, OH, USA

    Raymond I. Cho MD

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  1. Anaïs L. Carniciu MD
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  2. Raymond I. Cho MD
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  3. Alon Kahana MD PhD
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Correspondence to Alon Kahana MD PhD .

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Editors and Affiliations

  1. Oculofacial Plastic Surgeons of Georgia, Suwanee, GA, USA

    J. Javier Servat

  2. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Evan H. Black

  3. Beaumont Eye Institute, William Beaumont School of Medicine of Oakland University, Rochester, MI, USA

    Frank A. Nesi

  4. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Geoffrey J. Gladstone

  5. San Antonio Military Medical Center/Wilford Hall Ambulatory Surgery Center, Department of Ophthalmology and Oculoplastic Surgery, San Antonio, TX, USA

    Christopher J. Calvano

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Carniciu, A.L., Cho, R.I., Kahana, A. (2021). Surgical Management of Thyroid Eye Disease. In: Servat, J.J., Black, E.H., Nesi, F.A., Gladstone, G.J., Calvano, C.J. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-41720-8_58

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