Strabismus following implantation of Baerveldt drainage devices
M. Munoz and R. K. Parrish 2nd
Bascom Palmer Eye Institute, Miami, Fla.
OBJECTIVE: To describe the clinical features of strabismus following
implantation of a Baerveldt glaucoma seton. DESIGN: Case series of four
patients with a minimum follow-up of 6 months. SETTING: Specialized
glaucoma referral center at Bascom Palmer Eye Institute/Ann Bates Leach Eye
Hospital, Miami, Fla. PATIENTS: Consecutive sample of four patients with
persistent binocular diplopia following implantation of a 350-mm2 Baerveldt
glaucoma seton in the superotemporal quadrant. RESULTS: Each patient
presented with a characteristic pattern of either exotropia or hypertropia,
or both. The deviation increased with gaze opposite the ipsilateral
superior and lateral muscles and decreased in the field of action of the
involved muscles. All patients demonstrated a convergence insufficiency
type of exotropia. CONCLUSION: These patients presented with a similar type
of restrictive strabismus. Proposed mechanisms include an increase in the
length-tension curve of the muscle induced by the underlying bleb and a
posterior fixation effect as a result of scarring behind the implant.
