Académie royale de Médecine de Belgique

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Résumé de Lelio Baldeschi

DECOMPRESSION SURGERY IN THE TREATMENT OF GRAVE’S ORBITOPATHY

par Lelio BALDECHI (Service d’Ophtalmologie – UCLouvain), invité. 

Graves’ orbitopathy (GO) is a debilitating disease which adversely interferes with the quality of life of affected patients. It is characterised by different degrees of disfigurement and alterations in vision, both of which contribute to loss of self-confidence, psychosocial stability and ability to function.In GO, surgery, which may be necessary to protect visual function in the active phase of the disease or to correct the stable typical disfigurement and symptoms in the static post inflammatory phase should always be considered rehabilitative as it is aimed at restoring the individual integrity disrupted by the disease and ultimately the lost ability to function.Commonly, however surgery performed primarily to treat potentially sight threatening conditions such as optic neuropathy or exposure keratopathy is referred to as functional, while procedures primarily aimed at correcting disfigurement and symptoms are referred to as rehabilitative.  Besides these semantic considerations a clear-cut distinction between the two, does not exist as surgery aimed primarily at restoring function also has positive effects on disfigurement and vice versa.In this lecture current concepts, timing, techniques, aims, results and possible complications of functional and rehabilitative decompression surgery will be presented and discussed.