Christmann L M, Wilson M E
University of South Carolina School of Medicine, Department of Ophthalmology, Columbia.
J Pediatr Ophthalmol Strabismus. 1992 Jan-Feb;29(1):44-8. doi: 10.3928/0191-3913-19920101-09.
Molteno implants are gaining wide acceptance for refractory glaucoma in both children and adults. Such surgery led to vertical strabismus in three patients. Two children developed an inability to elevate the globe after Molteno implants were placed superiorly. One adult, whose Molteno implant was placed inferiorly, could not fully depress the globe postoperatively, and experienced vertical diplopia. This complication of Molteno implants was explored using forced duction testing and surgery. We feel a likely explanation for this is a Faden or posterior fixation suture effect induced by scarring under the rectus muscle. Patients undergoing this surgery should be counseled about possible postoperative diplopia, an especially devastating complication when the implant is placed inferiorly.
莫尔托诺植入物在儿童和成人难治性青光眼中越来越被广泛接受。这种手术导致三名患者出现垂直斜视。两名儿童在上方植入莫尔托诺植入物后出现眼球上抬障碍。一名下方植入莫尔托诺植入物的成人术后眼球不能完全下转，并出现垂直复视。通过强制牵拉试验和手术对莫尔托诺植入物的这种并发症进行了探究。我们认为，一个可能的解释是直肌下瘢痕形成引起的套索或后固定缝线效应。接受这种手术的患者应被告知术后可能出现复视，当植入物放置在下方时，这是一种特别严重的并发症。
