Is orbital decompression surgery for hyperthyroidism proptosis really risky?

  After a period of hormonal shock or self-recovery, patients enter the stable stage from the active stage, but the protruding orbital balls are still a permanent pain in the hearts of these patients. Since very few surgeons in China and abroad are able to perform this surgery and not many patients have undergone it, patients have little knowledge of the possible complications of the surgery and have serious fears, wondering how terrible the surgery is and what irreversible complications can occur.  In general, complications can occur in any surgery and affect the patient, and it is most closely related to two factors: the difficulty of the disease itself; and the skill level of the surgeon. Orbital decompression surgery is the largest surgery in ophthalmology and is performed by orbital specialists who are at least associate chief physicians, have been engaged in orbital surgery for more than fifteen years (not cataract, cosmetic and other ophthalmic surgery), have been in charge of orbital decompression surgery for more than ten years to do this surgery well, and have to complete at least fifty such surgeries every year. As for complications, they are roughly divided into short-term and long-term complications. Those that can be recovered within three months are generally called short-term complications, while those over six months are long-term complications, which mostly require further treatment to resolve, and there are also mild and severe complications.  Complications of orbital decompression surgery do not necessarily occur during or after surgery, but the most common and serious cases are as follows: 1. Intraoperative damage to the extraocular muscles: resulting in limited eye movement, diplopia and strabismus. This is a short-term complication that can be recovered within a month, with an incidence of 26% reported abroad. 2. Intraoperative damage to the optic nerve: leading to vision loss and even blindness. This article is a serious complication, not reported in China, foreign data show the incidence of 1/1000, and are in the open surgery decompression, so the incidence is very low. 3, postoperative decompression is not satisfactory, there is still eye protrusion: this article varies from person to person, highly protruding eyes are generally difficult to recover to the pre-onset level, for patients with very high requirements may appear unsatisfactory . 4, postoperative recurrence, need to again This is a rare case, unless the surgery is performed when the condition is not stable. 5. postoperative skin scarring, affecting the appearance: a concealed, minimally invasive incision is taken, leaving no scarring. 6. postoperative sunken eyes: for mild proptosis, this can sometimes occur in patients with high subjective requirements. 7. postoperative lower lid recession, entropion, and upper lid recession aggravation: the incidence is not high, and the more experienced the surgeon in charge, the lower the incidence. 8. The more experienced the surgeon, the lower the incidence. 8. Inferior displacement of the eye position: orbital decompression surgery involves knocking out the bone wall around the orbit and removing some of the orbital fat. Early on, the orbital fat is unbalanced and there will be some changes in the eye position. At the same time, the patient’s muscle contraction force changes at the same time, pulling the eye to shift. Sometimes, the position of the eyelid also changes after orbital decompression surgery, resulting in a relative displacement of the eye position. caused by surgical trauma.