ABSTRACT
The relative merit of operation in the treatment of Graves' ophthalmopathy as well as the extent of surgical resection is still a matter of debate. This work aimed at reporting the assessment of the impact of near-total thyroidectomy on the course of ophthalmopathy including exophthalmos. A total of 20 patients, with thyrotoxic goiters suffering from mild to moderate exophthalmos were enrolled onto this prospective study. Preoperative evaluation of ophthalmopathy was accomplished through the NOSPECS classification, MRI scanning for measuring the extraocular muscle diameters and measurement of the exophthalmos using Hertel's exophthalmometer. Six months postoperatively, ophthalmopathy including exophthalmos was re-evaluated using the same parameters mentioned before. Clinical activity evaluation, exophthalmometry and extraocular muscles measurement by MRI revealed that the majority of the cases experienced improvement of their ophthalmopathy [65%]. This improvement was statistically significant In addition, no major postoperative complications were observed. However, the study, unlike a number of reported retrospective ones, failed to specify any statistically significant prognostic factors affecting the course of ophthalmopathy possibly due to the limited number of cases in general In addition, all of the cases were of relatively young age and thyrotoxic, and the majority were females and non-smoking. Beside the fact that near-total thyroidectomy adds the advantages of total thyroidectomy [no recurrence] to those of subtotal thy-roidectomy [low incidence of temporary and permanent hypoparathyroidism], it has a significant positive impact on thyroid-associated orbitopathy