What is the effect of thyroidectomy on graves ophthalmopathy compared with other treatment modalities?
Ophthalmopathy occurs in about one third of patients with Graves’ disease, with 5% having moderate-to-severe eye disease. For those without ocular involvement or with only mild Graves’ eye disease, the outcome of the eye disease is felt to be equivalent among different treatment modalities. For patients with mild Graves’ eye disease being treated with radioiodine, concurrent use of glucocorticoids is recommended to decrease the risk of the eye disease worsening. Because of the transient increase in TSH receptor antibody level that occurs following radioiodine therapy and the concern for this exacerbating Graves’ ophthalmopathy, thyroidectomy is recommended for patients with active moderate-to-severe Graves’ ophthalmopathy.