Modified Deep Lateral Wall Decompression Surgery in the Treatment of Thyroid‐Associated Ophthalmopathy: A Retrospective Evaluation

ABSTRACT Background Thyroid‐associated ophthalmopathy (TAO) may lead to severe exophthalmos and dysthyroid optic neuropathy (DON), which can threaten visual function. Orbital decompression surgery is often required when medical therapy is insufficient; however, traditional deep lateral wall decompression techniques remain associated with several complications. Objective To evaluate the clinical efficacy and safety of modified deep lateral wall decompression surgery in patients with TAO and DON. Method This retrospective single‐arm study included sixteen patients who underwent modified deep lateral wall decompression at the Third Affiliated Hospital of Sun Yat‐sen University between January 2022 and May 2023, with a 3‐month postoperative follow‐up. Postoperative assessments included visual acuity, intraocular pressure, exophthalmos, ocular motility, diplopia, and complications. Results At 3 months postoperatively, patients showed significant improvement in visual acuity, exophthalmos, and intraocular pressure ( p < 0.001). The remission rate of postoperative limited ocular motility symptoms was 60% ( n = 10). Among the twelve patients with preoperative diplopia, 6 showed improvement in symptoms. No cases of cerebrospinal fluid (CSF) leakage or vibration‐induced diplopia occurred, and only one patient experienced temporary periorbital skin numbness, which resolved by 3 months. Conclusion The modified deep lateral wall decompression surgery shows promise as a potentially safer and effective treatment option for patients with TAO and DON, demonstrating improvements in vision, exophthalmos, and intraocular pressure with a low incidence of complications. However, these preliminary results warrant further validation in prospective or comparative controlled trials.