Department of Medicine, University of Otago Dunedin School of Medicine , Dunedin, New Zealand.
Department of Preventive and Social Medicine, University of Otago , Dunedin, New Zealand.
J Binocul Vis Ocul Motil. 2020 Apr-Jun;70(2):57-62. doi: 10.1080/2576117X.2020.1734431. Epub 2020 Mar 18.
To evaluate the development of postoperative strabismus causing diplopia in patients who received Molteno implant surgery for the treatment of glaucoma.
The Otago Glaucoma Surgery Outcome study (OGSOS) was used to select cases who had undergone Molteno implant surgery to examine the effect on the development of strabismus causing diplopia. Information was collected on treatments provided to correct motility disturbance, and their success, in this retrospective non-comparative study.
32 cases (3.3%) were found to have developed diplopia following the Molteno implant surgery from a total of 977 cases. Of these, the strabismus in 23 cases was described in sufficient detail to permit clinical categorization. Most (19/23) demonstrated an exodeviation, hyperdeviation, or a combination thereof, although 2/6 cases with superonasal plate location demonstrated a hypodeviation. Diplopia generally resolved spontaneously (20/32 cases). Treatment was required in eight cases, usually conservative and successful (6/8 cases), but strabismus surgery was required in two cases, and was unsuccessful.
This study found a low incidence of diplopia developing post-Molteno implant surgery. Strabismus features suggested a restrictive etiology, and spontaneous recovery was common (62.5%). Surgical correction proved unsuccessful - confirming persistent postoperative diplopia after Molteno implant surgery to be a rare but surgically challenging complication.
评估接受 Molteno 植入术治疗青光眼的患者术后斜视导致复视的发展情况。
采用奥塔戈青光眼手术结果研究（OGSOS）选择接受 Molteno 植入术的病例，以检查其对斜视引起复视发展的影响。在这项回顾性非对照研究中，收集了关于纠正运动障碍的治疗方法及其成功率的信息。
在总共 977 例患者中，有 32 例（3.3%）在 Molteno 植入术后出现复视。其中，23 例斜视的描述详细到足以进行临床分类。大多数（19/23）表现为外斜视、上斜视或两者的组合，尽管 6 例中有 2 例超鼻侧板位置的斜视表现为下斜视。复视通常会自行消失（20/32 例）。有 8 例需要治疗，通常是保守治疗且成功（6/8 例），但有 2 例需要斜视手术，且不成功。
本研究发现 Molteno 植入术后发生复视的发生率较低。斜视的特征提示其具有约束性病因，且自发性恢复较为常见（62.5%）。手术矫正证明不成功——这证实了 Molteno 植入术后持续存在的术后复视是一种罕见但具有挑战性的手术并发症。
