Diplopia in adult patients following cataract extraction and refractive surgery

Gunton, Kammi B.; Armstrong, Blair K.

doi:10.1097/icu.0b013e32833bd850

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…Preexisting strabological disorders are the second reason after anaesthesia related trauma for postoperative diplopia in cataract surgery [ 6 , 7 , 33 – 35 ]. Cataract can disrupt fusion due to sensory deprivation and that process is more likely to occur with preexisting heterophoria.…”

Section: Aetiologymentioning

confidence: 99%

“…A number of patients regain fusional ability within a few months after cataract extraction, so it is sensible to wait for a while before taking into account such serious measures as surgical treatment. Statistically speaking majority of treated patients benefit from conservative treatment (depending on the author, 60–80%) [ 6 , 7 , 33 , 44 ]. It can be applied early after the onset of symptoms and includes first of all prismatic correction, usually Fresnel prisms.…”

Section: Treatmentmentioning

confidence: 99%

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Diplopia as the Complication of Cataract Surgery

Gawęcki¹,

Grzybowski

2016

Journal of Ophthalmology

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The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery.

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Section: Aetiologymentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Diplopia as the Complication of Cataract Surgery

Gawęcki¹,

Grzybowski

2016

Journal of Ophthalmology

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“…Gunton & Armstrong () reported a higher incidence of diplopia—up to 1%—and ocular misalignment—up to 7%—in patients undergoing cataract surgery under retrobulbar anaesthesia.…”

Section: Resultsmentioning

confidence: 99%

Binocular vision alterations after refractive and cataract surgery: a review

García-Montero

Diego

Garzón

et al. 2018

Acta Ophthalmologica

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To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms.

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“…1 Patients may report visual symptoms such as diplopia and asthenopia that appear to be due to surgical complications causing strabismic and non-strabismic binocular vision anomalies. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Although these binocular vision problems and symptoms do not appear to be among the most common complications of cataract surgery, a review of the literature indicates that these problems do occur, and the reported prevalence varies from 0.093% to 6.8%. 6,11 While both strabismic [3][4][5]7,17,20 and non-strabismic 16,21,22 binocular vision disorders have been reported in the literature after cataract surgery, significant study limitations exist.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there is a lack of use of a validated symptom survey in previous studies, and typically, only the symptom of diplopia was studied. 4,[6][7][8][9][10][11][12][13][14][15][17][18][19]31 However, diplopia is only one of the symptoms associated with binocular vision disorders, and is more common in acquired strabismus. Finally, there is a lack of classification criteria for diagnostic conditions.…”

Section: Introductionmentioning

confidence: 99%

Cataract surgery is not associated with post‐operative binocular vision anomalies in age‐related cataract patients

Tan

Lewis

Lan

et al. 2022

Ophthalmic Physiologic Optic

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Purpose To compare the binocular vision status of patients pre‐ and post‐cataract surgery, and to investigate the risk factors for patients who develop binocular vision anomalies post‐surgery. Methods A prospective study of patients (≥50 years) who elected to undergo bilateral cataract surgery was implemented. A comprehensive binocular vision test battery including stereopsis, ocular alignment, fusional vergence, vergence facility, near point of convergence and the Convergence Insufficiency Symptom Survey (CISS) was administered before the first surgery and at the third visit after surgery on the second eye. A detailed diagnostic classification protocol was applied to identify the presence of binocular vision anomalies pre‐ and post‐surgery. Results Seventy‐three participants were included at baseline, 24 (33%) of whom were diagnosed with non‐strabismic binocular vision anomalies (NSBVA), mainly convergence insufficiency (18/73, 25%). Fifty‐one participants completed the post‐operative evaluation, 17 (33%) of whom had NSBVA pre‐surgery and 13 (26%) post‐surgery (p = 0.48). There were a number of conversions from NSBVA to normal binocular vision and vice versa. Logistic regression showed that the adjusted odds ratio of pre‐existing NSBVA diagnosis for predicting the risk of post‐operative NSBVA was 6.37 (p < 0.01). There were no significant changes in most binocular vision measures post‐surgery, except for a significant improvement in the CISS score (p < 0.01, Cohen's d = 0.83). Conclusions Binocular vision anomalies, especially convergence insufficiency, are prevalent in the age‐related cataract population. Cataract surgery does not appear to be a significant risk factor for the development of new binocular vision anomalies. A pre‐existing binocular vision anomaly is the main risk factor for predicting a post‐operative binocular vision anomaly in this population.

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Diplopia in adult patients following cataract extraction and refractive surgery

Abstract: Detailed history and evaluation for pre-existing strabismus can dramatically decrease the incidence of unexpected diplopia following refractive procedures.

Cited by 17 publications

References 30 publications

Diplopia as the Complication of Cataract Surgery

Diplopia as the Complication of Cataract Surgery

Binocular vision alterations after refractive and cataract surgery: a review

Cataract surgery is not associated with post‐operative binocular vision anomalies in age‐related cataract patients

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