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Diplopia after limited macular translocation surgery.
A N Buffenn1, E de Juan, G Fujii
1Johns Hopkins University School of Medicine, Baltimore, Md, USA.
Summary
Limited macular translocation rarely causes double vision (diplopia). Standard eye alignment tests may underestimate misalignment, but prisms often resolve symptoms, especially without retinal distortion.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Strabismus
Background:
- Full macular translocation can cause significant torsional diplopia.
- Limited macular translocation involves inducing retinal detachment and scleral imbrication for spontaneous reattachment.
Purpose of the Study:
- To characterize the occurrence and management of diplopia in patients undergoing limited macular translocation surgery.
Main Methods:
- Retinal translocation surgery was performed on 250 patients by two surgeons.
- Data on translocation extent, scleral imbrication, and diplopia complaints were recorded.
- Patients with diplopia underwent ocular motility evaluation and treatment.
Main Results:
- 5.2% of patients reported diplopia.
- Excyclotorsion ranged from 0 to 16 degrees.
- Prism-and-cover testing underestimated strabismus compared to subjective testing; prisms resolved diplopia in most cases.
Conclusions:
- Limited macular translocation infrequently leads to symptomatic diplopia.
- Traditional alignment tests may not reliably quantify misalignment after this procedure.
- Prism therapy is effective, particularly when retinal distortion or aniseikonia is absent.