Endocrine orbitopathy (Basedow-Graves' disease): Deformity after bony decompression according to Matton. Tissue regeneration with lipostructure

Endocrine Ophthalmopathy (EO) also known as Graves' Disease is a chronic, multisystem disorder characterized by increased intraorbital fat tissue and hypertrophic extraocular muscles caused by an autoimmune process. EO may be associated with the following main clinical findings: diplopia, exophthalmos, conjunctivitis, photophobia, chemosis, lagophthalmos, tearing, keratitis, upper and lower eyelid retraction, corneal ulceration resulting from the inability to close the eyelid, headache, retrobulbar pain, glaucoma and optic neuropathy caused by the increased intraorbital pressure. Different surgical techniques can be used: transpalpebral decompression by intraorbital fat removal (Olivari 's technique), three-wall bony decompression and in severe cases the complete removal of the lateral wall of the orbit (bony decompression according Matton). The aim of surgery is to reduce endo-orbital pressure and its consequences and clinical symptoms. The authors report a case of a patient with EO treated with bilateral transpalpebral decompression by intraorbital fat removal (Olivari's technique), bilateral three-wall bony decompression and at a secondary stage, left lateral orbital wall decompression according Matton. Matton decompression contour deformity of the left lateral orbital region was reconstructed with Lipostructure according to Coleman.