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Glaucoma

Study Examines Risk Factors for Strabismus Following Glaucoma Drainage Device (GDD) Implantation

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A new study in the Journal of American Association for Pediatric Ophthalmology investigated possible risk factors for strabismus following glaucoma drainage device (GDD) implantation for refractory childhood glaucoma. Strabismus is common in children after GDD implantation.

Investigators retrospectively reviewed the medical records of 81 consecutive patients (mean age, 7.9 ± 4.8 years) who underwent GDD implantation for refractory childhood glaucoma at Duke Eye Center from 2005 to 2016. Pre- and postoperative motility and alignment, best-corrected visual acuity, and demographic and surgical data were extracted. Glaucoma following cataract surgery was the most common glaucoma type and the Baerveldt 250 mm2 device was the most common GDD.

Thirty-eight patients (47%) had documented strabismus prior to GDD surgery, with 25 (31%) having new or worsened strabismus after GDD implantation. Of patients who had new or worsened strabismus, 16% was vertical, 60% was horizontal (exotropia, 48% of new/worsened; esotropia, 12% of new/worsened), and 24% was vertical and horizontal. There was new motility limitation in 32 of 81 (40%) patients.

Risk factors, including age, type/location/number of GDD, revision, motility limitation, glaucoma type, asymmetric visual acuity, and visual impairment, were not significantly associated with new or worsened post-GDD strabismus.

Reference:

Talsania SD, Nallasamy N, Lee AR, Freedman SF. Risk factors for strabismus following glaucoma drainage device implantation for refractory childhood glaucoma. JAAPOS. 2019;pii: S1091-8531(19)30087-4. doi: 10.1016/j.jaapos.2019.02.005. [Epub ahead of print].

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