Evaluation of Diplopia Secondary to Seton Implantation Surgery: Ahmed Glaucoma Valve and Diplopia

Objectives: To determine and evaluate the rate of diplopia after Ahmed glaucoma valve (AGV) implantation surgery. Materials and Methods: The records of patients who underwent AGV implantation in our hospital between the years of 2010 and 2017 were retrospectively reviewed. Patients who were referred to our strabismus department due to binocular diplopia after AGV implantation surgery were included. The details of postoperative day 1, day 7, day 15, and 1 month examinations were recorded. In the postoperative period, the onset time of diplopia complaints, diplopia type, and the presence of diplopia at distance and near fixation were noted. Ocular motility examination and deviation measurements were evaluated. Results: Ten (47%) of 211 patients who underwent AGV implantation in our hospital between 2010 and 2017 met the study inclusion criteria. Six of the 10 patients were men (60%) and 4 were women ( 40%). The mean age of the patients was 44.5 (34-63) years. Complaints of diplopia developed at a mean of 14.5 +/- 12.3 (1-30) days after AGV implantation. The prism measurements of the patients were found to be 8.4 +/- 1.4 prism diopters (PD) exotropia and 7.1 +/- 8.8 PD hypotropia. While 8 patients had diplopia only at near distance, 2 patients had diplopia at both distance and near. Three patients were treated with prismatic glasses, and their complaints of diplopia recovered spontaneously in 5.11 +/- 4.10 months. The other 7 patients were followed up without treatment, and their diplopia complaints resolved spontaneously in 6.11 +/- 4.40 months. Conclusion: Although most of the diplopia that develops after AGV implant surgery resolves without treatment, prismatic glasses might be considered as a treatment option in patients whose diplopia affects their daily lives.