Prospective evaluation of extraocular motility following double-plate Molteno implantation

Amber A. Dobhr-Dixon, Louis B. Cantor, Naval Sondhi, V. Steve Ku, Joni Hoop

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objective: To determine the incidence and type of extraocular motility disturbance after double-plate Molteno implantation. Methods: In a prospective clinical series, we evaluated preoperative and postoperative ocular motility at 3 and 6 months in 24 eyes of 24 patients undergoing double-plate Molteno implantation. Visual acuity, motility testing, and subjective and objective diplopia were evaluated at each examination. Results: Within the first 6 months postoperatively, new or worse strabismus developed in 11 (46%) of the 24 study patients. Three of the 11 patients had a generalized restriction of the superior rectus and the superior oblique muscles, all of which persisted 6 months after surgery. Four patients had clinical features consistent with an acquired Brown syndrome, and 6 months after surgery, 3 of the 4 patients had a residual deviation, although the deviation in 1 patient resolved. A superior oblique palsy developed in 3 patients, and a lateral rectus palsy developed in 1 patient. All 4 of the muscle palsies resolved or were resolving during the follow-up period, which ranged from 6 to 12 months. Conclusions: Extraocular motility disturbances are not rare after double-plate Molteno surgery. Muscle palsies, acquired Brown syndromes, and generalized restrictions occurred in similar proportions. Clinical Relevance: Patients should be counseled before Molteno surgery concerning the risk of strabismus and diplopia.

Original languageEnglish (US)
Pages (from-to)1155-1160
Number of pages6
JournalArchives of Ophthalmology
Issue number9
StatePublished - Sep 1999

ASJC Scopus subject areas

  • Ophthalmology

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