Willaert R, et al. - For studies published before August 2018, a systematic search was carried out in PubMed/MEDLINE, Web of Science, and Cochrane Library to evaluate the effectiveness and safety of fat removal orbital decompression (FROD) alone to treat exophthalmos in Graves’ orbitopathy. Thirteen observational studies were chosen from 1,908 records initially identified, representing 4,820 orbits in 2,514 patients. Five studies in 943 out of 1,172 patients reported an improvement in diplopia after surgery. Five studies, or 124 out of 1,277 patients, reported persistent new-onset diplopia. The efficacy and safety of FROD to treat mild-to-moderate exophthalmos in Graves’ orbitopathy was supported in this analysis. In order to improve the level of evidence, prospective and controlled trials are required. There have been no reported severe adverse events.