Heavy eye syndrome precipitated by superotemporal Ahmed glaucoma valve implantation in a woman with axial high myopia

A 56-year-old woman with pseudophakia and glaucoma was referred because of left eye hypotropia and esotropia noted following superotemporal Ahmed glaucoma valve implantation in that eye. Examination suggested left heavy eye syndrome, and it was confirmed the patient had high axial myopia before her cataract surgeries. Both nasal displacement of the left superior rectus muscle and inferior displacement of the left lateral rectus muscle were noted intraoperatively. Removal of the glaucoma drainage device, posterior loop myopexy of the superior rectus muscle to the lateral rectus muscle, and implantation of a new glaucoma drainage device inferonasally improved the strabismus.