Drainage devices in children can cause abnormal ocular motility

Ocular motility abnormalities and strabismus are common in children after aqueous drainage device surgery and these problems should be taken into account before proceeding with surgery, concludes a report published in the February issue of the Journal of the American Association of Pediatric Ophthalmology.

Erin O'Malley and colleagues from Duke University Medical Center, North Carolina, USA conducted a chart review of consecutive children treated with aqueous drainage devices between 1995 and 2006, looking for ocular motility abnormalities and strabismus as well as sensorimotor testing results before and after device placement.

A total of 38 eyes of 30 children with congenital glaucoma and 41 eyes of 32 children with aphakic glaucoma were included in the study. Following drainage device surgery, 14 and 20 eyes were >20/100 in the congenital and aphakic groups, respectively. Horizontal and vertical strabismus was common and occurred in 57% of congenital glaucoma patients and 47% of aphakic glaucoma patients. Motility limitation, both vertical and horizontal, was also common and occurred in 37% of patients overall.

These potential problems should be carefully considered before implanting a drainage device, caution the authors.