Chang Ta Chen, Cavuoto Kara M
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, United States.
World J Ophthalmol. 2014;4(3):25-28. doi: 10.5318/wjo.v4.i3.25. Epub 2014 Aug 12.
Binocular vision disturbance is a well-described complication of glaucoma drainage device (GDD) implantation. The pathophysiology is not well-understood, but may involve bulk effects from the implant and surrounding bleb, as well as modulation of muscle function due to surgical trauma and post-operative inflammation, resulting in a combined resection/posterior fixation effect. Retrospective studies have found the risks of motility disorder and diplopia vary widely, estimated to be 56%-86% and 57%-75%, respectively. More recently, cross-sectional studies and prospective trials estimate post-GDD incidence to be approximately 1%-44%, with the incidence in newer generation of implants designed to limit bleb size likely lower at 1%-5%. Suggested methods of management strategies include prismatic spectacles, monocular occlusion, extreme monovision, and strabismus surgery.
双眼视觉障碍是青光眼引流装置（GDD）植入术后一种广为人知的并发症。其病理生理机制尚未完全明确，但可能涉及植入物及周围滤过泡的体积效应，以及手术创伤和术后炎症对肌肉功能的调节，从而产生联合性切除/后固定效应。回顾性研究发现，眼球运动障碍和复视的风险差异很大，估计分别为56%-86%和57%-75%。最近，横断面研究和前瞻性试验估计，GDD植入术后的发生率约为1%-44%，而旨在限制滤过泡大小的新一代植入物的发生率可能较低，为1%-5%。建议的管理策略方法包括佩戴棱镜眼镜、单眼遮盖、极端单眼视力矫正和斜视手术。
