{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:17:56Z","timestamp":1788164276479,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the efficacy of secondary bony decompression following primary fat decompression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective interventional case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Setting: A tertiary university hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Population:<\/jats:title>\n                    <jats:p>A total of 27 eyes from 17 patients who underwent secondary inferomedial orbital wall decompression following primary orbital fat decompression were included. Patients with a history of trauma, extraocular muscle surgery, prior orbital irradiation, or eyelid or orbital inflammation within 6 months prior to decompression were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention Procedure:<\/jats:title>\n                    <jats:p>Secondary inferomedial orbital wall decompression performed for recurrent proptosis or compressive optic neuropathy after primary fat decompression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure:<\/jats:title>\n                    <jats:p>Changes in Hertel value, and best corrected visual acuity (BCVA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Primary orbital fat decompression achieved an initial proptosis reduction of 3.4 \u00b1 0.1 mm in 27 eyes. Secondary bony decompression was subsequently performed in 15 eyes from 9 patients with recurrent proptosis and in 12 eyes from 8 patients with dysthyroid optic neuropathy. Secondary bony decompression resulted in a reduction in Hertel measurement by 4.5 \u00b1 2.1 mm, improving from 21.7 \u00b1 2.8 mm to 17.3 \u00b1 1.6 mm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) at a follow-up period of 40.6 \u00b1 28.7 months. BCVA in patients with dysthyroid optic neuropathy improved from 0.43 \u00b1 0.3 to 0.12 \u00b1 0.15 logMAR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005). Diplopia occurred in 12 of 17 patients (70%), including five with new-onset diplopia. Preoperative diplopia predicted postoperative diplopia in regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Secondary inferomedial orbital wall decompression following primary orbital fat decompression effectively reduces proptosis and improves vision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3140_25","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:00:32Z","timestamp":1788163232000},"page":"1320-1324","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of secondary infero-medial orbital wall decompression after orbital fat decompression in Graves\u2019 orbitopathy: A 12-year experience"],"prefix":"10.4103","volume":"74","author":[{"given":"Anny M S","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Alaska Native Medical Center, Anchorage, AK, USA"},{"name":"Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Teng","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hsuan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan"},{"name":"College of Medicine, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Yi-chiun","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan"},{"name":"Department of Ophthalmology, Mackay Children\u2019s Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Bair","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Wills Eye Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Arts and Sciences, New York University, New York, NYC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Lang","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan"},{"name":"College of Medicine, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260831","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1038\/s41433-024-02967-9","article-title":"The changing landscape of thyroid eye disease: Current clinical advances and future outlook","volume":"38","author":"Moledina","year":"2024","journal-title":"Eye (Lond)"},{"key":"R2-20260831","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000443828","article-title":"The 2016 European Thyroid Association\/European Group on Graves\u2019 orbitopathy guidelines for the management of graves\u2019 orbitopathy","volume":"5","author":"Bartalena","year":"2016","journal-title":"Eur Thyroid J"},{"key":"R3-20260831","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1136\/bjophthalmol-2016-309888","article-title":"Long-term outcomes of orbital fat decompression in Graves\u2019 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