In the surgical treatment of residual or recurrent strabismus after previous surgery, procedures on EOMs that have not undergone prior surgery are technically easier and somewhat more predictable than on those that have. Unfortunately, when previous surgery has resulted in muscle restriction or weakness with limited duction (due to excessive recession or slipped or “lost” muscle), reoperation on the involved muscle is usually necessary. If the restriction is a result of retinal detachment surgery, correction can usually be accomplished without removal of scleral explants. For an eye that has previously undergone glaucoma surgery such as trabeculectomy or implantation of a tube shunt, strabismus surgery should be planned to minimize the risk of disrupting the filtering bleb.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.