Abstract
Purpose :
Strabismus and diplopia are one of the complications after glaucoma drainage implantation. The purpose of this investigation is to evaluate the incidence of extraocular motility disturbance and the ocular alignment change after Ahmed Glaucoma Valve (AGV) implantation.
Methods :
In this prospective clinical series, we consecutively evaluated preoperative and postoperative ocular motility and deviation in 36 eyes of 30 glaucoma patients who undergone AGV (model FP-7) implantation (15 men and 15 women; mean±SD age of 77.2±6.9 years). The ocular motility was tested by Hess chart, and the ocular deviation was tested by alternative prism cover test at far and near distances; the presence of diplopia was asked to the subjects. Postoperative examination was repeated at 3, 6, and 12 months after the surgery.
Results :
The AGV was implanted in the superior-temporal quadrant in 34 eyes and in the inferior-temporal quadrant in 2 eyes; 6 patients were implanted AGV bilaterally. Postoperatively, some extraocular motility restriction and/or heterotropia were found in all tested eyes although most of them were mild and asymptomatic. Eleven (37%) of thirty patients presented motility restriction toward the quadrant of the implantation. Three (10%) patients had reported symptomatic diplopia; all of these patients had the vertical ocular deviation changes of more than 5 prism diopters at both far and near distance at 12 months postoperatively.
Conclusions :
By the prospective comparisons between before and after the surgery, it is revealed that AGV implantation is associated with extraocular motility restriction and changes in ocular alignment. However, most of these events are asymptomatic or self-limiting, and additional interventions such as device explanation or strabismus surgery are not frequently required.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.