Purpose: To investigate the patient characteristics and therapeutic outcomes of diplopia resulting from strabismus after cataract surgery.
Subjects and methods: Of the patients who experienced diplopia after cataract surgery, 17 patients (mean age: 72.6 years, range: 60-82 years) who were diagnosed with strabismus and underwent strabismus surgery between August 2011 and July 2016 at Hyogo College of Medicine Department of Ophthalmology were examined. We retrospectively investigated the type of diplopia, the characteristics of strabismus, and the surgical outcome.
Results: The type of diplopia was cyclodiplopia in 15 patients (88.2%), crossed diplopia in 1 patient (5.9%), and vertical diplopia in 1 patient (5.9%). The type of strabismus was trochlear nerve palsy in 12 patients (70.6%), exotropia in 1 patient (5.9%), thyroid-associated ophthalmopathy (TAO) in 1 patient (5.9%), and idiopathic strabismus in 3 patients (17.6%). Inferior rectus (IR) muscle nasal transposition was performed in 14 of 15 patients (93.3%) for correcting cyclotropia (IR nasal transposition alone: 3 patients, combined with IR recession: 11 patients), while the transposition of the horizontal rectus muscles was performed in 1 remaining patient (6.7%). The advancement and recession of the medial and lateral rectus muscles was performed in one patient with exotropia (6.7%), and superior rectus muscle recession was performed in one patient with TAO (6.7%). Diplopia of far vision was eliminated in all patients (100%); however, it remained in two patients with near vision (11.8%) who required prism glasses.
Conclusions: Cyclotropia was found to be a cause of diplopia after cataract surgery. Cataract surgeons should be aware of potential cyclotropia because it is inconspicuous and challenging to detect before cataract surgery.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 753-757, 2018.