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Diplopia after cataract surgery: report of cases

Poster Details

First Author: G.Olavarri Gonzalez SPAIN

Co Author(s):    D. Fuentes Ventura   P. Gomez de LiaƱo   P. Merino Sanz   G. Franco Iglesias     

Abstract Details


To analyze the main features of binocular diplopia following cataract surgery in our hospital.


Review of medical records


Retrospectively, 186 patients with binocular diplopia who attended Adult Strabismus and Diplopia Department of our hospital from October 2013 to February 2014 were reviewed. 11 of these cases were secondary to cataract surgery. We grouped these patients according to the underlying mechanisms, including type of anaesthesia and muscle affectation. Besides this,the number of cataract surgeries performed during this period of three months were also recorded, in order to calculate the number of cases in which this complication appeared.


Persistent binocular diplopia occurred in 1 of 505 eyes after cataract surgery. None of the patients in whom cataract surgery was conducted with topical or general anesthesia had diplopia, whereas 1 of the 154 eyes in which cataract surgery was done after sub-anesthesia was affected. Regarding to the analysis of 186 medical records, 11 cases (5.91%) of diplopia following cataract surgery were found: 8 cases (72.72%) were caused by a muscle injury related to the anesthetic technique (6 inferior rectus muscle and 2 superior rectus), 2 cases (18.18%) by stopping the prolonged sensory deprivation caused by cataract in an amblyopic eye and 1 case (9,09%) by a pre-existing paresis of the fourth cranial nerve. The following treatments were used in the 11 studied cases: prisms were prescribed in 3 patients, botulinum toxin injection in 2 patients, muscle surgery in 2 patients and the association of botulinum toxin injection and muscle surgery in the last 3 patients. The possibility of retreatment with botulinum toxin injection is being considered in two patients due to lack of response, while the remaining cases are asymptomatic at the moment of the study.


Diplopia after cataract surgery is an infrequent but troublesome complication in a surgery that,otherwise, would be successful. The most common cause of diplopia found in this group is muscle injury related to the anesthetic technique, being the muscle rectus inferior the most affected. Most of the cases require muscle treatment, overall with a good response. FINANCIAL INTEREST: NONE

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