Surgical Responses of Medial Rectus Muscle Recession in Thyroid Eye Disease-Related Esotropia

We evaluate the surgical outcomes and surgical responses of medial rectus muscle (MR) recession patients with thyroid eye disease (TED)-related esotropia (ET). The surgical dose-response curves 1 week postoperatively and at the final visit were analyzed. Univariable and multivariable linear regression analyses were applied to investigate factors influencing surgical dose-response. A total of 43 patients with TED-related ET that underwent MR recession were included. The final success rate was 86.0% and the rate of undercorrection was 14.0%. The surgical dose-response curves of TED-related ET showed a gentle slope compared with those of standard surgical tables. In the univariable model, simultaneous vertical rectus muscle recession was the only significant factor influencing surgical dose-response of MR recession in TED-related ET (β = -0.397, P = 0.044). In a model adjusted for age, sex, type of surgery, and preoperative horizontal angle of deviation, simultaneous vertical rectus muscle recession showed marginal significance (β = -0.389, P = 0.064). The surgical dose-response curve of TED-related ET was unique. Simultaneous vertical rectus muscle recession was associated with increased surgical dose-response in TED-related ET.     

A patient with bacteraemia and possible endocarditis caused by a recently-discovered genomospecies of Capnocytophaga: Capnocytophaga genomospecies AHN8471: a case report

Introduction

A case of severe acute bilateral angle closure glaucoma with complete visual loss after oral topiramate therapy.

Case presentation

A 34 year-old woman developed bilateral severe visual loss 2 days after doubling the dosage of topiramate. Her best-corrected visual acuity (BCVA) was counting fingers in both eyes (OU). Intraocular pressures were 49 mm and 51 mm of Hg in right and left eyes respectively, with conjunctival chemosis, corneal edema, shallow anterior chamber and closed angles on gonioscopy. B-scan ultrasound revealed annular peripheral choroidal effusions in both eyes.

Conclusion

Intraocular pressures and anterior chamber depth were normalized after discontinuation of topiramate and initiation of antiglaucoma therapy. Two weeks later, visual acuities improved to 20/25 in the right eye and 20/40 in the left eye. B-scan ultrasound showed resolution of choroidal effusion. Topiramate, an oral sulpha-derivative medication is known to cause ciliochoroidal effusions, which lead to forward rotation of the ciliary body and displacement of the lens-iris diaphragm, with resultant acute angle closure glaucoma and myopic shift.     

Congenital cataract in a cynomolgus monkey

The anterior part of the eye was examined with 1,531 newborn cynomolgus monkeys (Macaca fascicularis). A male (about 0.07%) of those newborns was noticed to have white opacities in his both eyes (Fig. 1). This finding was diagnosed to be bilateral congenital cataract by observing with a slit-lamp biomicroscope. Partial resorption of the white opaque part occurred one week after birth in the right eye (Fig. 2) and three weeks after birth in the left eye (Fig. 3). As a result of the resorption, observation of the ocular fundus by an ophthalmoscope became possible at two and seven weeks of age in the right and left eyes, respectively (Figs. 6 and 7), even though the ophthalmoscopic figures were not complete. White opacities occupied again nearly the whole area of the lens at 10 months of age in the left eye (Fig. 4) and at 14 months of age in the right eye (Fig. 5). Breeding studies are needed to determine if this case has any genetic background.     

Visual loss as initial presentation of chronic myelogenous leukemia

A previously healthy 17-year old girl presented with sudden visual loss in both eyes. Visual acuity on the right eye was 0.3 and on the left eye 0.1. Fundoscopic examination showed bilateral optic disc edema, retinal venous tortuousity and dilatation, retinal blot and flame-shaped hemorrhages, Roth spots and on the left eye dark blot preretinal hemorrhage covering the fovea. Laboratory evaluation showed white blood cell count of 455 x 10(9) L. Bone marrow biopsy confirmed the diagnosis of chronic myelogenous leukemia. Chemotherapy was initiated and led to the improvement of visual acuity. Fundus changes had resolved except for the preretinal hemorrhage on left eye which decreased in size. Preretinal hemorrhage in fovea caused maculopathy on the left eye. Three months after admisson visual acuity was 1.0 on the right eye and 0.3 on the left eye. Leukemia should always be included in the differential diagnosis of optic disc edema and retinal hemorrhages.     

Asymmetries in the sense organs and central nervous system of the squid Histioteuthis

The visual system of Histioteuthis is markedly asymmetrical, in that the eyes and optic lobes are considerably larger on the left side, and the lens of the left eye is often yellower in colour than that of the right eye. At the histological level, the rhabdomes of the retinas of both eyes show the usual rectilinear pattern typical of cephalopods. Unlike other species described, however, the orientation of the pattern is not uniform over the retina. The optic lobes are well developed on both sides, again following the typical squid pattern, although the plexiform and inner granular layers are thicker on the left side. In life it is likely that the animals orient at an oblique angle with the arms downward, and the left eye pointing upwards and the right eye downwards, and the asymmetries of the visual system are probably related to this posture. No corresponding asymmetries in the statocysts or other parts of the central nervous system have, however, been detected     

Long-term functional outcomes after 10 years of bilateral cochlear implantat use

The aims were to determine the benefit of bilateral cochlear implantation in a 20 years old patient implanted in Croatia on hearing and speech development. The male patient, after 10 years of deafness, got cochlear implants Med-EL Combi 40+ on both sides in one-stage surgery. The etiology of his deafness was posttraumatic meningitis. Auditory capacity and speech recognition tests were performed for both ears separately and together Average hearing level on the right ear with right cochlear implant switched on started at 62 dB 1 month after the cochlear implantation and was on 55 dB after 10 years. Average hearing level on the left ear with left cochlear implant switched on started at 55 dB 1 month after the cochlear implantation and was on 32 dB after 10 years. Average hearing level on the both ears with 2 cochlear implants switched on started at 35 dB 1 month after the cochlear implantation and was on 27 dB after 10 years. Long-term functional outcomes with bilateral cochlear implantation provides advantages over unilateral implantation including improved hearing level, speech perception in noise and improved sound localization.     

不同角膜表面处理方式在全飞秒SMILE手术中的应用效果分析

摘要 目的：探讨不同角膜表面处理方式在全飞秒SMILE手术中的应用效果。方法：选择2021年10月至2022年9月来我院择期行全飞秒SMILE手术的患者50例,根据先右后左手术原则,观察眼与对照眼没有固定左右眼,观察眼25例选择右眼,25例选择左眼,对照眼反之选择另一眼,观察眼使用开睑器开睑后用三角海绵擦拭清洁角膜表。对照眼眼自净（眨眼）后使用开睑器开眼睑。对比观察眼与对照眼的角膜光密度、角膜表面颗粒物质计数、角膜表面湿度、术中负压吸引完成时间、失吸比例、OBL发生率,分析50例患者的舒适度。结果：观察眼的角膜光密度为16.33±2.12,对照组为16.85±2.58,组间对比无统计学意义（t=-1.101,P=0.274）。对照眼的表面颗粒物质计数明显较观察眼低,角膜表面湿度明显较观察眼高（P<0.05）。对照眼与观察组术中负压吸引完成时间、失吸比例对比无统计学意义（P>0.05）。观察眼中OBL发生率为6.00 %,对照眼中OBL发生率为2.00 %,组间对比无统计学意义（P=0.617>0.05）。50例患者中对三角海绵擦拭角膜感觉恐惧者占比32.00%（16/50）,三角海绵擦拭角膜后对注视绿点存在影响者占比20.00 %（10/50）,手术中选择三角海绵擦拭角膜者20例,占比40.00 %（20/50）,选择眼自净（眨眼）者30例,占比60.00 %（30/50）。结论：眼自净（眨眼）可以代替三角海绵擦拭角膜,用于全飞秒SMILE手术,提高患者舒适度。     

Electron microscopic study of larval eye development in Turbellaria Polycladida

The appearance and development of the embryonic and larval eyes of the polyclad turbellarian Stylochus mediterraneus were studied. In the embryo, the left epidermal eye appears first. Subsequently, the right epidermal eye appears, and within hours it sinks into the parenchyma and turns into a cerebral eye. Newly hatched Götte's larvae possess both the left epidermal and the right cerebral eye. Three days after hatching, an incomplete eye appears adjacent to the left epidermal eye. The left cerebral eye then originates from this incomplete eye as it sinks into the parenchyma. This third eye is believed to originate through a process of induction.     

Moyamoya syndrome following growth hormone-secreting pituitary adenoma

We report a case of Moyamoya syndrome developing in association with growth hormone-secreting pituitary adenoma. A 31-year-old female presented with acromegalic features. Magnetic resonance imaging revealed a 1 × 2 cm tumor in the sella turcica and MR angiography demonstrated unremarkable findings. Blood growth hormone and insulin-like growth factor I levels were elevated to 74.1 ng/ml and over 1 575 ng/ml, respectively. The diagnosis was growth hormone-secreting pituitary adenoma, and the tumor was removed through a transsphenoidal approach. Four years after surgery, she visited the outpatient department due to left side weakness for 2 months. Magnetic resonance images showed acute and old infarcted lesions in the basal ganglia and subcortical area and residual small pituitary adenoma in the sellar area. MR angiography demonstrated stenosis of the bilateral distal internal carotid arteries with basal collateral vessels. Conventional cerebral angiography showed complete obstruction in the right internal carotid artery and severe stenosis of the left internal carotid artery, middle cerebral artery, and anterior cerebral artery with basal collateral vessels. Her blood growth hormone and insulin-like growth factor I levels were 15.3 ng/ml and 1 055 ng/ml, respectively. We believe that excess systemic exposures of growth hormone and insulin-like growth factor I may participate in the development of Moyamoya syndrome.     

AquaLase versus NeoSoniX--a comparison study

Aims: To compare the metrics and surgical outcome when using Infiniti AquaLase and NeoSoniX cataract removal modalities. Methods: This prospective clinical study involved 50 patients with bilateral cataracts and lens removal using AquaLase in the right eye and NeoSoniX in the left eye. Best corrected visual acuity (BCVA), endothelial cell density and pachymetry were evaluted pre- and postoperatively. Statistical analysis was performed using the Wilcoxon Signed- Rank Test. Results: Preoperative mean pachymetry was 569 +/- 31 mu in the right eye (RE) and 560 +/- 37 mu in the left eye (LE), mean endothelial cell density 2744 +/- 418 cells/mm(2) (RE) and 2730 +/- 472 cells/mm(2) (LE). One week after operation pachymetry was 576 +/- 52 mu (RE) and 583 +/- 72 mu (LE) and endothelial cell density 2388 +/- 586 cells/mm(2) (RE) and 2463 +/- 615 cells/mm(2) (LE). One month after surgery pachymetry was 556 +/- 43 mu (RE) and 559 +/- 44 mu (LE) and endothelial cell density 2368 +/- 52 cells/mm(2) (RE) and 2495 +/- 548 cells/mm(2) (LE). BCVA improved in all eyes and was 0.8 or better on the first postoperative day. Conclusions: Both the NeosoniX and AquaLase minimize intraoperative damage to ocular structures.     

Lateralization and unilateral transfer of spatial memory in marsh tits: are two eyes better than one?

Two previous experiments on food storing and one-trial associative learning in marsh tits (Clayton 1992a; Clayton and Krebs 1992) demonstrate that information coming into the brain from the left eye disappears from the left eye system between 3 and 24 h after memory formation, whereas that coming into the brain from the right eye remains stable within the right eye system for at least 51 h after memory formation. Performance after a 7 h retention interval appears to represent an intermediate stage in which the information is no longer accessible to the left eye system but is not yet available to the right eye system, suggesting a unilateral transfer of memory. The experiments reported here further investigated lateralization and unilateral transfer of memory in food-storing marsh tits, Parus palustris, using the technique of monocular occlusion. Birds were tested for their ability to retrieve stored seeds after retention intervals of 3, 7 and 24 h under 4 different occlusion treatments. Two predictions were tested: (a) with right eye occlusion during storage, birds should show better memory performance after 3 and 24 h than after 7 h and (b) memory should be more accurate when both eyes are used during storage than with monocular occlusion. The first prediction, which arises from the fact that memory is transferred from the left to the right eye system at about 7 h and is inaccessible during the transfer, was supported by the data. The second prediction, however, was not supported. Previous work has shown that in marsh tits the two eye systems remember preferentially different aspects of the stimulus: the left eye system responds to spatial position and the right eye system to object-specific cues. It is possible that the failure to find superior performance in binocular tests was because the task could be solved by either spatial or object-specific memory.     

Development of lateralization of the magnetic compass in a migratory bird

The magnetic compass of a migratory bird, the European robin (Erithacus rubecula), was shown to be lateralized in favour of the right eye/left brain hemisphere. However, this seems to be a property of the avian magnetic compass that is not present from the beginning, but develops only as the birds grow older. During first migration in autumn, juvenile robins can orient by their magnetic compass with their right as well as with their left eye. In the following spring, however, the magnetic compass is already lateralized, but this lateralization is still flexible: it could be removed by covering the right eye for 6 h. During the following autumn migration, the lateralization becomes more strongly fixed, with a 6 h occlusion of the right eye no longer having an effect. This change from a bilateral to a lateralized magnetic compass appears to be a maturation process, the first such case known so far in birds. Because both eyes mediate identical information about the geomagnetic field, brain asymmetry for the magnetic compass could increase efficiency by setting the other hemisphere free for other processes.     

Optic nerve regeneration after intravitreal peripheral nerve implants: trajectories of axons regrowing through the optic chiasm into the optic tracts

We have studied axon regeneration through the optic chiasm of adult rats 30 days after prechiasmatic intracranial optic nerve crush and serial intravitreal sciatic nerve grafting on day 0 and 14 post-lesion. The experiments comprised three groups of treated rats and three groups of controls. All treated animals received intravitreal grafts either into the left eye after both left sided (unilateral) and bilateral optic nerve transection, or into both eyes after bilateral optic nerve transection. Control eyes were all sham grafted on day 0 and 14 post-lesion, and the optic nerves either unlesioned, or crushed unilaterally or bilaterally. No regeneration through the chiasm was seen in any of the lesioned control optic nerves. In all experimental groups, large numbers of axons regenerated across the optic nerve lesions ipsilateral to the grafted eyes, traversed the short distal segment of the optic nerve and invaded the chiasm without deflection. Regeneration was correlated with the absence of the mesodermal components in the scar. In all cases, axon regrowth through the chiasm appeared to establish a major crossed and a minor uncrossed projection into both optic tracts, with some aberrant growth into the contralateral optic nerve. Axons preferentially regenerated within the degenerating trajectories from their own eye, through fragmented myelin and axonal debris, and reactive astrocytes, oligodendrocytes, microglia and macrophages. In bilaterally lesioned animals, no regeneration was detected in the optic nerve of the unimplanted eye. Although astrocytes became reactive and their processes proliferated, the architecture of their intrafascicular processes was little perturbed after optic nerve transection within either the distal optic nerve segment or the chiasm. The re-establishment of a comparatively normal pattern of passage through the chiasm by regenerating axons in the adult might therefore be organised by this relatively immutable scaffold of astrocyte processes. Binocular interactions between regenerating axons from both nerves (after bilateral optic nerve transection and intravitreal grafting), and between regenerating axons and the intact transchiasmatic projections from the unlesioned eye (after unilateral optic nerve lesions and after ipsilateral grafting) may not be important in establishing the divergent trajectories, since regenerating axons behave similarly in the presence and absence of an intact projection from the other eye.     

Selective laser trabeculoplasty in the treatment of pseudoexfoliation glaucoma in patients allergic to all anti-glaucoma drops

Secondary chronic open-angle glaucoma associated with pseudoexfoliation (PEX) syndrome accounts for approximately 25% of all glaucomas and represents the most common identifiable cause of glaucoma overall. Selective laser trabeculoplasty (SLT) is effective in reducing intraocular pressure (IOP) in glaucomatous patients and has the advantage of preserving surrounding structures. We report here SLT treatment of a 82 year old female with a secondary developed open-angle pseudoexfoliation glaucoma allergic to all anti glaucoma eye drops especially those which contain bensalconium chloridum as preservative. Since patient was allergic also to methyl-cellulose, we performed SLT with water as a mediator. Patient had PEX syndrome for 10 years, immature cataracts on both eyes, and best corrected visual acuity (BCVA) 0.7 on the right and 0.2 on the left eye. We have monitored intraocular pressure (IOP), the changes in the visual field and optic nerve. Preoperative IOP was 28 mmHg on the right and 30 mmHg on the left eye. The follow up period was 24 months with time points for measured parameters every 3 months. After 18 months IOP remained in the normal values (average 17 mmHg) on the right eye, but on the left eye it increased up to 28 mmHg. SLT re-treatment was carried out on the left eye and the IOP stabilized again on the values between 16-18mmHg. There were no significant change in the visual field and optic nerve configuration before and after SLT (C/D value for right eye: 0.3-0.4; C/D left eye: 0.5). Based on this case report, SLT seems to be very effective treatment for maintaining regular IOP in patient with PEX who is allergic to all types of medications.     

Behavioral and neural lateralization of vision in courtship singing of the zebra finch

Along with human speech and language processing, birdsong has been one of the best-characterized model systems for understanding the relationship of lateralization of brain function to behavior. Lateralization of song production has been extensively characterized, and lateralization of song perception has begun to be studied. Here we have begun to examine whether behavior and brain function are lateralized in relation to communicative aspects of singing, as well. In order to monitor central brain function, we assayed the levels of several activity dependent immediate early genes after directed courtship singing. Consistent with a lateralization of visual processing during communication, there were higher levels of expression of both egr-1 and c-fos in the left optic tectum after directed singing. Because input from the eyes to the brain is almost completely contralateral in birds, these results suggest that visual input from the right eye should be favored during normal singing to females. Consistent with this, we further found that males sang more when they could use only their right eye compared to when they could use only their left eye. Normal levels of singing, though, required free use of both eyes to view the female. These results suggest that there is a preference for visual processing by the right eye and left brain hemisphere during courtship singing. This may reflect a proposed specialization of the avian left hemisphere in sustaining attention on stimuli toward which a motor response is planned.     

斜视矫正手术对双眼视觉功能影响的临床研究

目的:探讨斜视矫正手术对双眼视觉功能的影响。方法:将收集的85例斜视患者根据斜视类型分组,共同性外斜视组51例,占60.00%;共同性内斜视组16例,占18.82%。麻痹性斜视组13例,占15.30%,特殊类型斜视组5例,占5.88%。同视机检查并记录患者术前及术后双眼视功能情况。结果:外斜视手术方式多选用单眼外直肌后徙+内直肌缩短术,内斜视手术主要选用双眼内直肌后徙术,上斜肌麻痹多行患眼下斜肌适量后徙或转位术,麻痹性内斜和外斜手术方式为患眼水平肌后徙联合缩短术,外斜V征手术方式为双眼外直肌后徙联合上移半个肌腱,伴有斜肌亢进者需同时行斜肌减弱术,固定性内斜1例手术方式为患眼内直肌断键+直肌联结术。85例患者术后正位73例(85.89%),双眼视觉功能手术前后比较有显著性差异(P0.05),术后较术前可见明显改善。结论:斜视矫正手术可促进双眼视觉功能的恢复,尤其是对于学龄前儿童效果更明显。     

Analysis of human tear fluid by Fourier transform infrared spectroscopy

The purpose of this research is to find some useful spectroscopic factors in human tear fluid contents to monitor diurnal changes of the physicochemical ocular conditions noninvasively. All tear fluid samples were collected with glass microcapillary tubes from both eyes of three donors and analyzed by Fourier transform infrared spectroscopy with attenuated total reflectance (FTIR-ATR). We measured the peak intensities at 2852, 1735, 1546, and 1242 cm(-1), and the peak intensity ratios among those peaks in the second derivative spectra. We found significant diurnal and individual variations in those peak intensities for tear fluid obtained from right and left eyes. Among these variations, we observed significant changes in tear samples between right and left eyes. In this case the peak intensity ratio between 1242 (phosphate ester) and 2852 cm(-1) (fatty acid methylene) of right eye tear fluid was increased in the afternoon (1600 to 1900 h), while that of left eye tear fluid did not change significantly. In the ratio between 1242 (phosphate ester) and 1546 cm(-1) (amide II), the difference was not observed between both eyes. We conclude that the difference in diurnal variations of biochemical constituents between right and left eye tear fluids could be monitored noninvasively and nondestructively by FTIR technique and this method could be useful in the future for tear diagnoses.     

Subthalamic Nucleus Stimulation Affects Theory of Mind Network: A PET Study in Parkinson's Disease

Background

There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson''s disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism.

Methodology/Principal Findings

To this end, we conducted ¹⁸FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucose metabolism and impaired ToM in several cortical areas: the bilateral cingulate gyrus (BA 31), right middle frontal gyrus (BA 8, 9 and 10), left middle frontal gyrus (BA 6), temporal lobe (fusiform gyrus, BA 20), bilateral parietal lobe (right BA 3 and right and left BA 7) and bilateral occipital lobe (BA 19). There were also correlations between increased cerebral glucose metabolism and impaired ToM in the left superior temporal gyrus (BA 22), left inferior frontal gyrus (BA 13 and BA 47) and right inferior frontal gyrus (BA 47). All these structures overlap with the brain network that mediates ToM.

Conclusion/Significance

These results seem to confirm that STN DBS hinders the ability to infer the mental states of others and modulates a distributed network known to subtend ToM.     

Frontalis Muscle Flap Suspension for the Correction of Congenital Blepharoptosis in Early Age Children

Background

We aimed to report our successful use of frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children.

Methods

This retrospective study included 61 early age children (41 boys, 20 girls) with an average age of 6 years (range, 3–10 years) with congenital blepharoptosis who received surgery during the period from March 2007 to January 2011. There were 39 cases of unilateral blepharoptosis and 22 cases of bilateral blepharoptosis, thus a total of 83 eyes were affected. If patient had bilateral blepharoptosis, both eyes were operated on in the same surgery. Patients were followed for 3 months to 5 years. The procedure was performed without complications in all cases.

Results

The postoperative healing grade was good in 81 eyes (97.6%); the correction of blepharoptosis was satisfactory, the double eyelid folds were natural and aesthetic, the eyelid position and the curvature were ideal, and the eyes were bilaterally symmetrical. The postoperative healing grade was fair in 2 eyes (2.4%); blepharoptosis was improved compared with that before surgery. At discharge, lagophthalmos was noted in 10 eyes of which 4 cases resolved by the last follow-up. The remaining 6 cases were mild. Eleven eyes received reoperation for residual ptosis after the first surgery. The curvature of the palpebral margin was not natural in 4 eyes. These unnatural curvature possibly was caused by an excessively low lateral fixation point or postoperative avulsion.

Conclusion

Frontalis muscle flap suspension under general anesthesia for the correction of congenital blepharoptosis in early age children can achieve good surgical results.     

Horizontal Eye Position in Thyroid Eye Disease: A Retrospective Comparison with Normal Individuals and Changes after Orbital Decompression Surgery

Objective

To compare horizontal eye positions between proptotic thyroid eye disease patients and normal individuals, and to examine positional changes after orbital decompression surgery in thyroid eye disease patients.

Methods

The present case-controlled and retrospective comparative study included 78 proptotic thyroid eye disease patients who underwent bilateral orbital decompression surgery [lateral orbital wall decompression (Group L), 47 patients; medial orbital wall decompression (Group M), 9 patients; and balanced orbital decompression (Group B), 22 patients] and 143 age-matched healthy volunteers as controls. The interpupillary distance was measured to determine horizontal eye positions before and 3 months after surgery in thyroid eye disease patients and was also examined in control eyes. Horizontal eye shifts were calculated by subtracting postoperative from preoperative interpupillary distances.

Results

Preoperative interpupillary distances in thyroid eye disease patients were significantly larger than in controls. The interpupillary distances were significantly decreased postoperatively in Groups M and B, but were significantly increased in Group L. The order of the magnitude of the horizontal shifts was Groups M>B>L.

Conclusions

Proptotic thyroid eye disease patients preoperatively showed laterally displaced eyes in comparison with controls. However, the eyes shifted medially after the medial orbital wall decompression and the balanced orbital decompression, although the former showed more shift. Medial orbital wall or balanced orbital decompression can be used to correct both lateral and anterior displacement of the eyes.