Incidence of ocular misalignment and diplopia after uneventful cataract surgery

Purpose: To evaluate the incidence of ocular misalignment and diplopia afte r uneventful cataract surgery. Setting: An outpatient private practice eye institute. Methods: One hundred thirty-eight patients referred to 1 cataract surgeon w ere prospectively evaluated. Orthoptic evaluations were performed within 1 month before and then 1 day, 1 week, and 1 month after cataract surgery. An esthesia was by retrobulbar injection. and cataract extraction was done by phacoemulsification. Results: Cataract surgery was performed in 118 patients. Preoperatively, 16 patients had ocular misalignment; 10 were phoric, 4 were intermittently tr opic, and 2 were tropic. Follow-up evaluation was obtained for 101 patients (86%) at 1 day, 91 (77%) at 1 week, and 88 (75%) at 1 month. A change in o cular alignment occurred in 22 of 101 patients (22%) at 1 day, 9 of 91 (10% ) at 1 week, and 6 of 88 (7%) at 1 month. Only 1 patient who had a change i n alignment at 1 month was symptomatic. Conclusions: A persistent change in ocular alignment after uneventful catar act surgery occurred in 7% of patients. However. symptomatic diplopia was u ncommon (1 in 118; 0.85%) in this relatively small series. J Cataract Refra ct Surg 2000; 26:1205-1209 (C) 2000 ASCRS and ESCRS.