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Abstract #72623 Published in IGR 18-4
Strabismus surgery outcomes in eyes with glaucoma drainage devices
Osigian CJ; Cavuoto KM; Rossetto JD; Sayed M; Grace S; Chang TC; Capo HJournal of AAPOS 2017; 21: 103-106.e2
PURPOSE: To report strabismus surgery outcomes in eyes with prior implantation of glaucoma drainage devices (GDD). METHODS: The medical records of patients who underwent strabismus surgery for ocular misalignment that developed after implantation of a GDD over a 13-year period at a single institution were examined retrospectively. Patient characteristics, deviation types, preoperative measurements, surgical procedures, and postoperative measurements were analyzed. RESULTS: Of the 16 patients included, 14 had exotropia (34(Δ) ± 16(Δ)) and 11 had vertical deviations (15(Δ) ± 7(Δ)), of which 9 had concurrent exotropia and vertical deviations. Preoperatively, 9 patients had diplopia. The surgical approach was tailored to address the deviation most noticeable to the patient-horizontal, vertical, or both if the vertical component could be addressed by horizontal muscle supra- or infraplacement. Three patients underwent simultaneous horizontal and vertical surgery. All patients underwent strabismus surgery on an eye with a GDD. Surgical motor success (defined as horizontal deviation ≤10(Δ), vertical ≤4(Δ)) was achieved in 42% of horizontal and 57% of vertical deviations. Postoperatively 74% of deviations decreased by ≥50% in magnitude. Diplopia resolved in 50% of patients who presented with preoperative diplopia. One patient had intraoperative bleb perforation, but none had postoperative hypotony at any follow-up visit. Only 2 required a second strabismus surgery. CONCLUSIONS: Strabismus surgery with preservation of the filtering bleb following implantation of a glaucoma drainage device is a low risk procedure that can improve ocular alignment and related symptoms, despite a low motor success rate by standard criteria.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida.
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
