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The following is a summary of “A meta-analysis of the efficacy of two-wall orbital decompression operations for thyroid-associated ophthalmopathy,” published in the February 2024 issue of Ophthalmology by Jinhai et al.

Orbital decompression surgery is the primary treatment for proptosis and optic nerve compression in thyroid-associated ophthalmopathy, with medial inferior wall and balanced decompression being common procedures; yet, selecting between them lacks a standardized approach.

Researchers conducted a retrospective study to conduct a meta-analysis comparing the outcomes of medial inferior wall decompression and balanced decompression surgeries, aiming to offer guidance for optimal clinical decision-making.

They conducted a search across various databases, including PubMed, Web of Science, Ovid, Cochrane Library, and ClinicalTrials.gov, spanning from their inception to March 21, 2023. The search targeted randomized controlled trials and cohort studies focusing on decompression surgery for thyroid-associated ophthalmopathy. Utilizing RevMan 5.3 software, they performed a meta-analysis, examining outcome measures such as proptosis, diplopia rate, intraocular pressure, visual acuity, and complication rate.

The results showed that In a randomized controlled trial and five cohort studies, 377 patients were analyzed. Following balanced decompression surgery, individuals with thyroid-associated ophthalmopathy experienced a notable decrease in proptosis [MD = 4.92, 95% CI (4.26, 5.58), P<0.0001]. Balanced decompression demonstrated positive effects on postoperative visual acuity [MD = -0.35, 95% CI (-0.56, -0.13), P=0.001] and intraocular pressure [MD = 5.33, 95% CI (3.34, 7.32), P<0.0001]. The rates of proptosis [MD = 0.33, 95% CI (-1.80, 2.46), P=0.76] and diplopia [OR = 1.20, 95% CI (0.38, 3.76), P=0.76] did not exhibit significant differences between patients who underwent medial inferior wall decompression and those who underwent balanced decompression.

Investigators concluded that both balanced and medial inferior wall decompression offer effective surgical options for thyroid-associated ophthalmopathy, but the choice may depend on individual factors and surgeon preference.

Source: link.springer.com/article/10.1007/s10792-024-03039-3