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A lady was experiencing dryness and pain in one of her eyes for about a year. She was diagnosed with thyroid eye disease 2014, underwent decompression surgery later that year, but did not like the her results. In 2016, she underwent eyelid surgery, but was still unhappy with the results. She is now considering another decompression surgery, and wants to hear other doctors’ opinions on this.
New York oculoplastic and reconstructive surgeon Amiya Prasad, M.D. reviews her concerns in this video, and discusses the pros and cons of the different options for revision surgery for thyroid eye disease, orbital decompression, and eyelid retraction:
1:48 - Dr. Prasad details his background training in cosmetic oculofacial plastic and reconstructive surgery, and his experience as a specialist in eyelid surgery related to thyroid eye disease
2:51 - The two phases of thyroid eye disease (inflammatory phase and fibrotic phase); why doctors try to avoid operating during the inflammatory phase; and how to determine whether someone is in the fibrotic stage
4:10 - How thyroid eye disease is characterized by increased eye prominence due to proptosis; and how decompression surgery best addresses this type of issue
4:42 - The importance of being clear with the exact outcome or change one wants to see; and how eye projection can be further addressed with bony orbital decompression
5:42 - How prominence of the eyes in relation to eyelid retraction can be addressed with additional eyelid surgery, and the risks and benefits of the procedure
7:11 - How minimal retrusion of the eyeball after fat decompression can comfort for the patient; and how bony orbital decompression is best saved for severe cases
7:54 - Why discussing issues with original surgeon is important
9:00 - The limits of restoring appearance to prior to thyroid eye disease
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