Ocular motility changes and diplopia in sutured versus unsutured implantation of the Baerveldt glaucoma device

Abstract

Purpose To investigate the effect of two surgical techniques in primary Baerveldt glaucoma implant (BGI) surgery, that is the sutured technique and the unsutured (free) plate technique, on the ocular motility and prevalence of diplopia. We hypothesize that the free plate technique results in a lower diplopia prevalence. Methods We performed a prospective study of patients who underwent BGI surgery with the free plate technique and compared them with patients from a previous study who had undergone BGI surgery with the sutured technique. Their ductions, ocular alignment and fusion range and the prevalence of diplopia were measured before surgery and at 3 months, 6 months and 1 year postoperatively. Results We analysed 57 free plate and 51 sutured plate patients. One year postoperatively, we found no statistically significant difference in the prevalence of diplopia between the two techniques. All duction changes between baseline and 1‐year follow‐up were restrictions and occurred statistically significantly more frequently in the free plate than in the sutured plate group (p = 0.03; 60% versus 34%). About the ocular alignment, in the horizontal direction, a change in exodirection was more common in both groups, while in the vertical direction, a hyperdeviation of the operated eye was more common. The vertical ocular alignment change was smaller in the free plate group than in the sutured plate group (p = 0.04 at near and p = 0.02 at distance). Conclusions One year postoperatively, the prevalence of diplopia was not significantly different between patients with the sutured plate and patients with the free plate technique. Both surgical techniques induce diplopia and changes in ocular motility and/or in ocular alignment.

Magnetic resonance imaging reveals possible cause of diplopia after Baerveldt glaucoma implantation

“…The study protocol adhered to the tenets of the Declaration of Helsinki. Patients were retrospectively selected from previous studies in which diplopia and motility impairment was investigated until 1 year after BGI surgery [ 8 , 17 ]. In- and exclusion criteria of these studies are previously described in detail [ 8 , 17 ].…”

“…Patients were retrospectively selected from previous studies in which diplopia and motility impairment was investigated until 1 year after BGI surgery [ 8 , 17 ]. In- and exclusion criteria of these studies are previously described in detail [ 8 , 17 ]. Patients were excluded when monocular diplopia was present, they had a history of strabismus or were monocular.…”