Diplopia after cataract surgery

Purpose: To evaluate the cause of diplopia after cataract surgery. Setting: Cataract surgery at 7 hospitals and examination of diplopia at a c entral eye hospital. Methods: This study comprised 18 eyes of 17 patients with diplopia that dev eloped after cataract surgery in which retrobulbar anesthesia was used. The Hess screen test was done to diagnose oculomotor dysfunction. Results: Several cases showed superior or inferior deviation of the globe, but most patients had nonuniform disturbances of eye movement. Examination of 3 patients by the Hess chart within 1 week after surgery showed paralysi s of eye muscles but an overaction at a later stage, evident by reversal of eye position 1 month later. Surgery for strabismus was performed in 6 case s. One case with diplopia improved spontaneously 3 months after cataract su rgery and achieved good alignment. Conclusions: The Hess screen test was useful for comparing changes in oculo motor function before and after surgery. Oculomotor dysfunction after catar act surgery may be caused directly by traumatic injury during administratio n of anesthesia or surgery using bridle sutures or indirectly from sensitiv ity to anesthetic agents. J Cataract Refract Surg 2000; 26: 1198-1204 (C) 2 000 ASCRS and ESCRS.