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Persisting diplopia after bilateral laser in situ keratomileusis
D Holland1, M Amm, W de Decker
1University Eye Hospital, Kiel, Germany. dholland@ophthalmol.uni-kiel.de
Journal of Cataract and Refractive Surgery
|October 18, 2000
Summary
Persistent double vision after laser eye surgery can occur in patients with significant differences in vision between eyes and lazy eye. Ocular muscle surgery may not be an option if binocular vision is absent. Pre-operative binocularity assessment is crucial for refractive surgery candidates.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Binocular Vision
Background:
- Bilateral laser in situ keratomileusis (LASIK) is a common refractive surgery procedure.
- High anisometropia (significant difference in refractive error between eyes) and amblyopia (lazy eye) can present challenges in visual correction.
- Diplopia (double vision) is a potential, though uncommon, complication following refractive surgery.
Observation:
- A case of persistent diplopia following bilateral LASIK is presented.
- The patient had high anisometropia and amblyopia.
- The diplopia persisted despite the refractive surgery.
Findings:
- Ocular muscle surgery was not a viable treatment option for the persistent diplopia.
- The lack of fusion (the brain's ability to combine images from both eyes) prevented successful surgical intervention.
- This highlights a specific challenge in managing post-LASIK diplopia in patients with pre-existing binocular vision deficits.
Implications:
- A thorough pre-operative examination of binocular vision is essential before undertaking refractive surgery.
- This is particularly important for patients with high anisometropia.
- Ensuring adequate binocular function pre-surgery may help prevent or mitigate complications like persistent diplopia.