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Related Experiment Videos

Motility disturbances after Molteno implants.

L M Christmann1, M E Wilson

  • 1University of South Carolina School of Medicine, Department of Ophthalmology, Columbia.

Journal of Pediatric Ophthalmology and Strabismus
|January 1, 1992
PubMed
Summary
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Molteno implants for refractory glaucoma can cause vertical strabismus. Scarring under rectus muscles may induce a Faden effect, leading to debilitating double vision, especially with inferior implant placement.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Oculoplastics

Background:

  • Molteno implants are increasingly used for refractory glaucoma in pediatric and adult patients.
  • Glaucoma surgery aims to reduce intraocular pressure and preserve vision.

Observation:

  • Three patients developed vertical strabismus after Molteno implant surgery.
  • Two pediatric patients experienced inability to elevate the globe with superiorly placed implants.
  • One adult patient with an inferiorly placed implant had limited globe depression and vertical diplopia.

Findings:

  • Forced duction testing and surgical exploration were used to investigate the strabismus.
  • A likely cause is a Faden or posterior fixation suture effect due to scarring under the rectus muscle.

Related Experiment Videos

  • Scarring beneath the rectus muscle can restrict ocular motility.

    • Implications:

    • Patients should be informed about the risk of postoperative diplopia.
    • Inferior implant placement carries a higher risk of devastating vertical diplopia.
    • Understanding this complication can guide surgical technique and patient counseling.