Kilgore Khin P, Wang Feng, Stern Nicole C, Sabbagh Nouran, Jamali Sepideh, White Launia J, Sit Arthur J, Bitrian Elena, Roddy Gavin W, Mohney Brian G, Khanna Cheryl L
Departments of Ophthalmology.
Department of Ophthalmology, First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.
J Glaucoma. 2021 Jul 1;30(7):579-584. doi: 10.1097/IJG.0000000000001886.
Diplopia was present in ~20% of patients with Ahmed FP7 (FP7) or Baerveldt 350 (B350), compared with 5% to 6% in those with Baerveldt 250 (B250) or controls, suggesting risk of diplopia should be included in preoperative counseling.
The purpose of this study was to examine the prevalence of diplopia and strabismus in patients with B250, B350, or FP7 glaucoma drainage devices (GDD).
In this cohort study, glaucoma patients 18 years and above who had received, or would be receiving, a B250, B350, or FP7 GDD, and medically treated controls were consecutively enrolled from August 8, 2017, through July 31, 2019. The Diplopia Questionnaire was administered ≥30 days postoperatively, and upon enrollment to the controls. All diplopic patients underwent orthoptic measurements, which were reviewed by a strabismus specialist. Patients with GDDs in quadrants other than superotemporal, multiple GDDs, or scleral buckles were excluded. Bonferroni correction was applied for pairwise comparisons.
Diplopia was reported in 23/129 (17.8%) GDD patients and 5/99 (5.1%) control patients (P=0.003): 8/35 (22.9%) FP7, 2/32 (6.3%) B250, and 13/62 (21.0%) B350, with significant differences between FP7 versus controls (P=0.014) and B350 versus controls (P=0.011). Diplopia was attributable to GDD in 2 FP7 (5.9%, 95% confidence interval: 0.7-19.2), 0 B250, and 4 B350 (6.5%, 95% confidence interval: 1.7-15.2) patients, without significant differences between the GDDs.
Patients with the larger (B350) or the higher profile plate (FP7) GDDs were more likely to experience diplopia than controls, and diplopia was attributable to the GDD in ~6% of patients with either a FP7 or a B350 GDD. Since diplopia can affect patients' quality of life, preoperative counseling for GDD surgery, particularly B350 and FP7, should include a discussion of the risk of diplopia.
在使用艾哈迈德FP7（FP7）或贝尔维尔德350（B350）的患者中，约20%出现复视，而使用贝尔维尔德250（B250）的患者或对照组中这一比例为5%至6%，提示术前咨询应包括复视风险。
本研究旨在探讨使用B250、B350或FP7青光眼引流装置（GDD）的患者中复视和斜视的患病率。
在这项队列研究中，2017年8月8日至2019年7月31日连续纳入18岁及以上已接受或即将接受B250、B350或FP7 GDD的青光眼患者以及接受药物治疗的对照组。术后≥30天以及对照组入组时进行复视问卷调查。所有复视患者均接受斜视测量，并由斜视专家进行评估。象限不在颞上、有多个GDD或巩膜扣带的患者被排除。采用Bonferroni校正进行两两比较。
129例GDD患者中有23例（17.8%）报告有复视，99例对照患者中有5例（5.1%）报告有复视（P = 0.003）：FP7组35例中有8例（22.9%），B250组32例中有2例（6.3%），B350组62例中有13例（21.0%），FP7组与对照组之间（P = 0.014）以及B350组与对照组之间（P = 0.011）存在显著差异。2例FP7患者（5.9%，95%置信区间：0.7 - 19.2）、0例B250患者和4例B350患者（6.5%，95%置信区间：1.7 - 15.2）的复视归因于GDD，各GDD组之间无显著差异。
使用较大型号（B350）或较高轮廓板（FP7）GDD的患者比对照组更易出现复视，约6%使用FP7或B350 GDD的患者复视归因于GDD。由于复视会影响患者生活质量，GDD手术（尤其是B350和FP7）的术前咨询应包括对复视风险的讨论。
