Skip to main content

Advertisement

SpringerLink
Log in

Change in ocular alignment after topical anesthetic cataract surgery

  • Cataract
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To report the incidence of, and change in ocular misalignment following topical anesthetic cataract surgery.

Methods

Prospectively, 160 consecutive patients who were scheduled for cataract surgery under topical anesthesia were evaluated. All patients had a complete ophthalmic examination, including ocular alignment evaluation, just before and 1 day, 1 week, 3 weeks, and 2 months after cataract surgery.

Results

Preoperatively, 26 patients had ocular misalignment. Mean deviation in these preexisting misalignment was 7.2 ± 6.8 prism diopters (PD). Postoperatively, the angle of deviation improved to 5.4 ± 7.4 PD. Acquired ocular misalignment after cataract surgery occurred in 12 of 160 patients (8%) at 1 day, and seven of 131 (5%) at 2 months. None of these seven patients sought medical attention for the diplopia.

Conclusions

The overall incidence of topical anesthesia-related change in ocular alignment after uneventful cataract surgery was 5%. However, no patients had symptomatic diplopia. Topical anesthetic cataract surgery could abolish the risk of postoperative diplopia and improve the heterophoric status of preexisting misalignment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Reference

  1. Hamed LM, Helveston EM, Ellis FD (1987) Persistent binocular diplopia after cataract surgery. Am J Ophthalmol 103:741–744

    PubMed  CAS  Google Scholar 

  2. Rosenbaum AL (1997) Strabismus following uncomplicated cataract surgery. Arch Ophthalmol 115:253

    PubMed  CAS  Google Scholar 

  3. Koide R, Honda M, Kora Y, Ozawa T (2000) Diplopia after cataract surgery. J Cataract Refract Surg 26:1198–1204, doi:10.1016/S0886-3350(00)00369-2

    Article  PubMed  CAS  Google Scholar 

  4. Catalano RA, Nelson LB, Calhoun JH, Schatz NJ, Harley RD (1987) Persistent strabismus presenting after cataract surgery. Ophthalmology 94:491–494

    PubMed  CAS  Google Scholar 

  5. Pratt-Johnson JA, Tillson G (1989) Intractable diplopia after vision restoration in unilateral cataract. Am J Ophthalmol 107:23–26

    PubMed  CAS  Google Scholar 

  6. Hamed LM (1991) Strabismus presenting after cataract surgery. Ophthalmology 98:247–252

    PubMed  CAS  Google Scholar 

  7. Hamilton SM, Elsas FJ, Dawson TL (1993) A cluster of patients with inferior rectus restriction following local anesthesia for cataract surgery. J Pediatr Ophthalmol Strabismus 30:288–291

    PubMed  CAS  Google Scholar 

  8. Capo H, Guyton DL (1996) Ipsilateral hypertropia after cataract surgery. Ophthalmology 103:721–730

    PubMed  CAS  Google Scholar 

  9. Golnik KC, West CE, Kaye E, Corcoran KT, Cionni RJ (2000) Incidence of ocular misalignment and diplopia after uneventful cataract surgery. J Cataract Refract Surg 26:1205–1209, doi:10.1016/S0886-3350(00)00330-8

    Article  PubMed  CAS  Google Scholar 

  10. Johnson DA (2001) Persistent vertical binocular diplopia after cataract surgery. Am J Ophthalmol 132:831–835, doi:10.1016/S0002-9394(01)01233-8

    Article  PubMed  CAS  Google Scholar 

  11. MacDonald IM, Reed GF, Wakeman BJ (2004) Strabismus after regional anesthesia for cataract surgery. Can J Ophthalmol 39:267–271

    PubMed  Google Scholar 

  12. Yanguela J, Gomez-Arnau JI, Martin-Rodrigo JC, Andueza A, Gili P, Paredes B, Porras MC, Gonzalez del Valle F, Arias A (2004) Diplopia after cataract surgery: comparative results after topical or regional injection anesthesia. Ophthalmology 111:686–692, doi:doi:10.1016/j.ophtha.2003.11.002

    Article  PubMed  Google Scholar 

  13. Sharkey JA, Sellar PW (1994) Acquired central fusion disruption following cataract extraction. J Pediatr Ophthalmol Strabismus 31:391–393

    PubMed  CAS  Google Scholar 

  14. Crandall AS (2001) Anesthesia modalities for cataract surgery. Curr Opin Ophthalmol 12:9–11, doi:10.1097/00055735-200102000-00003

    Article  PubMed  CAS  Google Scholar 

  15. Gomez-Arnau JI, Yanguela J, Gonzalez A, Andres Y, Garcia del Valle S, Gili P, Fernandez-Guisasola J, Arias A (2003) Anaesthesia-related diplopia after cataract surgery. Br J Anaesth 90:189–193, doi:10.1093/bja/aeg029

    Article  PubMed  CAS  Google Scholar 

  16. Rainin EA, Carlson BM (1985) Postoperative diplopia and ptosis. A clinical hypothesis based on the myotoxicity of local anesthetics. Arch Ophthalmol 103:1337–1339

    PubMed  CAS  Google Scholar 

  17. Kushner BJ (1988) Case report. Ocular muscle fibrosis following cataract extraction. Arch Ophthalmol 106:18–19

    PubMed  CAS  Google Scholar 

  18. Birch AA, Evans M, Redembo E (1995) The ultrasonic localization of retrobulbar needles during retrobulbar block. Ophthalmology 102:824–826

    PubMed  CAS  Google Scholar 

  19. Capo H, Roth E, Johnson T, Munoz M, Siatkowski RM (1996) Vertical strabismus after cataract surgery. Ophthalmology 103:918–921

    PubMed  CAS  Google Scholar 

  20. Erie JC (1990) Acquired Brown's syndrome after peribulbar anesthesia. Am J Ophthalmol 109:349–350

    PubMed  CAS  Google Scholar 

  21. Esswein MB, von Noorden GK (1993) Paresis of a vertical rectus muscle after cataract extraction. Am J Ophthalmol 116:424–430

    PubMed  CAS  Google Scholar 

  22. Grimmett MR, Lambert SR (1992) Superior rectus muscle overaction after cataract extraction. Am J Ophthalmol 114:72–80

    PubMed  CAS  Google Scholar 

  23. Holmes JM, Leske DA, Hohberger GG (2008) Defining real change in prism-cover test measurements. Am J Ophthalmol 145:381–385, doi:10.1016/j.ajo.2007.09.012

    Article  PubMed  Google Scholar 

  24. Pediatric Eye Disease Investigator Group (2009) Interobserver reliability of the prism and alternate cover test in children with esotropia. Arch Ophthalmol 127:59–65, doi:10.1001/archophthalmol.2008.548

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Seung Ah Chung, Chan Yoon Kim, Samin Hong, Sung Yong Kang, Gong Je Seong & Jong Bok Lee

  2. Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, Korea

    Jee Ho Chang

  3. Department of Ophthalmology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Jong Bok Lee

Authors
  1. Seung Ah Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chan Yoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jee Ho Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Samin Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sung Yong Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gong Je Seong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jong Bok Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jong Bok Lee.

Additional information

None of the authors has any financial interest in this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chung, S.A., Kim, C.Y., Chang, J.H. et al. Change in ocular alignment after topical anesthetic cataract surgery. Graefes Arch Clin Exp Ophthalmol 247, 1269–1272 (2009). https://doi.org/10.1007/s00417-009-1084-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-009-1084-8

Keywords

Search

Navigation