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Abstract #15567 Published in IGR 1-3
Prospective evaluation of extraocular motility following double-plate molteno implantation
Dobler-Dixon AA; Cantor LB; Sondhi N; Ku WS; Hoop JArchives of Ophthalmology 1999; 117: 1155-1160
OBJECTIVE: To determine the incidence and type of extraocular motility disturbance after double-plate Molteno implantation. METHODS: In a prospective clinical series, the authors evaluated preoperative and postoperative ocular motility at three and six months in 24 eyes of 24 patients undergoing double-plate Molteno implantation. Visual acuity, motility testing, and subjective and objective diplopia were evaluated at each examination. RESULTS: Within the first six months postoperatively, new or worse strabismus developed in 11 (46%) of the 24 study patients. Three of the 11 patients had a generalized restriction of the superior rectus and the superior oblique muscles, all of which persisted six months after surgery. Four patients had clinical features consistent with an acquired Brown syndrome, and six months after surgery, three of the four patients had a residual deviation, although the deviation in one patient resolved. A superior oblique palsy developed in three patients, and a lateral rectus palsy developed in one patient. All four of the muscle palsies resolved or were resolving during the follow-up period, which ranged from 6-12 months. CONCLUSIONS: Extraocular motility disturbances are not rare after double-plate Molteno surgery. Muscle palsies, acquired Brown syndromes, and generalized restrictions occurred in similar proportions. CLINICAL RELEVANCE: Patients should be counselled before Molteno surgery concerning the risk of strabismus and diplopia.
Dr. A.A. Dobler-Dixon, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN; USA
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
