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Purpose To compare the decompressive effect around the optic nerve canal among 3 different decompression procedures (medial, balanced, and inferomedial) using 3D printed models. Methods In this experimental study, based on data obtained from 9 patients (18 sides) with dysthyroid optic neuropathy, a preoperative control model and 3 plaster decompression models were created using a 3D printer (total, 72 sides of 36 models). A pressure sensor was placed at the optic foramen, and the orbital space was filled with silicone. The surface of the silicone was pushed down directly, and changes in pressure were recorded at 2-mm increments of pushing. Results At 10 mm of pushing, there was significantly lower pressure in the medial (19,782.2 ± 4319.9 Pa,  P  = 0.001), balanced (19,448.3 ± 3767.4 Pa,  P  = 0.003), and inferomedial (15,855.8 ± 4000.7 Pa,  P    0.050). Conclusion All 3 commonly performed decompression procedures significantly reduced retrobulbar pressure. Because inferomedial decompression models obtained the greatest reduction in pressure on the optic nerve canal, inferomedial decompression should be considered the most reliable procedure for rescuing vision in dysthyroid optic neuropathy.

Comparison of the decompressive effect of different surgical procedures for dysthyroid optic neuropathy using 3D printed models