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Cataract surgery with topical anesthesia yields minimal postop misalignment
Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1269-1272.
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Cataract surgery with topical anesthesia was associated with a low incidence of postop ocular misalignment, a study showed.
"Topical anesthetic cataract surgery could abolish the risk of postoperative diplopia and improve the heterophoric status of pre-existing misalignment," the study authors said.
Persistent binocular diplopia or misalignment after cataract surgery with local anesthesia has been attributed to pre-existing thyroid eye disease, sensory deprivation from cataract, optical aberrations, surgical or anesthetic trauma to extraocular muscles or orbital soft tissue, and other factors, the authors said.
The prospective study included 160 patients scheduled to undergo cataract surgery with topical anesthesia. Patients underwent a complete ophthalmic examination, including assessment of ocular alignment, before surgery and 1 day, 1 week, 3 weeks and 2 months after surgery.
Twenty-six patients had pre-existing ocular misalignment before surgery. The mean angle of deviation in cases of pre-existing misalignment was 7.2 ΔD; the mean deviation after surgery was 5.4 ΔD.
Postoperatively, acquired ocular misalignment was seen in 12 of 160 patients (8%) at 1 day and seven of 131 patients (5%) at 2 months. No patients reported symptomatic diplopia, the authors said.