Concurrent adjacent strabismus surgery with glaucoma drainage device placement in childhood glaucomas

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Ultrasound Cyclo Plasty in Eyes with Glaucoma
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Ultrasound Cyclo Plasty in Eyes with Glaucoma

Published on: January 26, 2018

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Adam Jacobson1, Brenda L Bohnsack2,3

  • 1Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI, 48105, USA.

BMC Ophthalmology
|January 3, 2024
PubMed

Insights

Concurrent strabismus surgery with glaucoma drainage device (GDD) placement in children effectively reduced horizontal deviation and controlled intraocular pressure (IOP). This combined approach is crucial for optimizing visual development and improving appearance in pediatric glaucoma patients.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Management

Background:

  • Strabismus and glaucoma frequently coexist in pediatric patients.
  • Surgical correction of strabismus concurrent with glaucoma drainage device (GDD) placement is a potential management strategy.

Purpose of the Study:

  • To evaluate the outcomes of simultaneous strabismus surgery and GDD implantation in children.
  • To assess the efficacy of combined surgery in managing horizontal deviation and intraocular pressure (IOP).

Main Methods:

  • Retrospective review of pediatric patients undergoing lateral rectus (LR) muscle surgery and superotemporal GDD placement.
  • Success defined by residual horizontal misalignment <10 prism diopters (PD), IOP <21 mmHg, no severe complications, and no further IOP-lowering surgeries.

Main Results:

  • Fifteen eyes of 13 pediatric patients underwent combined surgery.
  • Significant reduction in final IOP (12.4 ± 4.7 mmHg) and glaucoma medications.
  • Strabismus success rate was 38% (5/13), and GDD success rate was 69% (9/13).
  • Two patients required further strabismus surgery, and two required tube revision with endoscopic cyclophotocoagulation.

Conclusions:

  • Concurrent strabismus surgery and GDD placement effectively decreases horizontal deviation and achieves IOP control in children.
  • Addressing strabismus during GDD surgery is vital for maximizing visual development and cosmetic outcomes in pediatric glaucoma.
  • This combined surgical approach offers a viable option for managing complex cases in pediatric ophthalmology.
Abstract

Keywords:
Childhood glaucomasEsotropiaExotropiaStrabismusglaucoma drainage device

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