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Acute comitant esotropia after cataract surgery.

Panayotis Zafirakis1, Adamantia Voudouri, Gerasimos Livir-Rallatos

  • 1Uveitis and Ocular Inflammation Service, Athens, Greece. zafiraki@hol.gr

Journal of Cataract and Refractive Surgery
|February 1, 2002
PubMed
Summary

Cataract surgery can cause comitant esotropia in patients with prior accommodative esotropia. This horizontal strabismus complication, especially in those with poor binocularity, requires patient counseling.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery

Background:

  • Accommodative esotropia is a common condition often managed in pediatric and adult ophthalmology.
  • Patients with pre-existing binocular vision anomalies are at higher risk for complications following ocular surgery.

Observation:

  • A 52-year-old woman with a history of accommodative esotropia developed comitant esotropia post-cataract surgery.
  • Preoperative assessment revealed peripheral fusion with central suppression, indicating subnormal binocularity.

Findings:

  • The patient experienced immediate postoperative diplopia and comitant esotropia, necessitating extraocular muscle surgery.
  • Horizontal strabismus is a potential complication following cataract surgery in individuals with a history of accommodative esotropia and compromised binocular function.

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Implications:

  • This case highlights the importance of discussing the risk of acquired horizontal strabismus after cataract surgery.
  • Ophthalmologists should carefully evaluate binocular status in patients with accommodative esotropia before proceeding with cataract extraction.
  • Informed consent should include the possibility of developing strabismus and the need for potential surgical intervention.