title: Strabismus surgery outcomes in eyes with glaucoma drainage devices.
abstract: OBJECTIVE
  To report strabismus surgery outcomes in eyes with prior implantation of glaucoma drainage devices (GDD).
  
  
  METHODS
  The medical records of patients who underwent strabismus surgery for ocular misalignment that developed after implantation of a GDD over a 13-year period at a single institution were examined retrospectively. Patient characteristics, deviation types, preoperative measurements, surgical procedures, and postoperative measurements were analyzed.
  
  
  RESULTS
  Of the 16 patients included, 14 had exotropia (34Δ± 16Δ) and 11 had vertical deviations (15Δ± 7Δ), of which 9 had concurrent exotropia and vertical deviations. Preoperatively, 9 patients had diplopia. The surgical approach was tailored to address the deviation most noticeable to the patient-horizontal, vertical, or both if the vertical component could be addressed by horizontal muscle supra- or infraplacement. Three patients underwent simultaneous horizontal and vertical surgery. All patients underwent strabismus surgery on an eye with a GDD. Surgical motor success (defined as horizontal deviation ≤10Δ, vertical ≤4Δ) was achieved in 42% of horizontal and 57% of vertical deviations. Postoperatively 74% of deviations decreased by ≥50% in magnitude. Diplopia resolved in 50% of patients who presented with preoperative diplopia. One patient had intraoperative bleb perforation, but none had postoperative hypotony at any follow-up visit. Only 2 required a second strabismus surgery.
  
  
  CONCLUSIONS
  Strabismus surgery with preservation of the filtering bleb following implantation of a glaucoma drainage device is a low risk procedure that can improve ocular alignment and related symptoms, despite a low motor success rate by standard criteria.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Osigian
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida.
authors.forename: Kara M
authors.initials: KM
authors.lastname: Cavuoto
authors.affiliation: Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Julia D
authors.initials: JD
authors.lastname: Rossetto
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sayed
authors.affiliation: University of North Carolina at Chapel Hill, Kittner Eye Center, Chapel Hill, North Carolina.
authors.forename: Sara
authors.initials: S
authors.lastname: Grace
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida.
authors.forename: Ta C
authors.initials: TC
authors.lastname: Chang
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Department of Ophthalmology, Miami, Florida. Electronic address: hcapo@med.miami.edu.
authors.forename: Hilda
authors.initials: H
authors.lastname: Capo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013285:Strabismus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult