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Strabismus after regional anesthesia for cataract surgery
Ian M MacDonald1, George F Reed, Bradley J Wakeman
1Department of Ophthalmology, University of Alberta, Royal Alexandra Hospital, Edmonton, Alta.
Summary
Postoperative diplopia after cataract surgery with regional anesthesia occurs in approximately 2.6 per 1000 procedures. Management may involve prisms or strabismus surgery.
Area of Science:
- Ophthalmology
- Anesthesiology
- Strabismus Management
Background:
- Adult strabismus clinic data used to assess diplopia risk post-cataract surgery.
- Regional anesthesia's role in postoperative diplopia investigated.
Purpose of the Study:
- Estimate the incidence of postoperative diplopia following cataract surgery under regional anesthesia.
- Describe patient management strategies for this complication.
Main Methods:
- Retrospective cohort analysis of patients referred over 22 months.
- Review of surgical and anesthetic records for injection details and anesthesia type/volume.
- Prospective study of diplopia evolution and management.
Main Results:
- 21 patients (63-88 years) developed postoperative diplopia.
- Vertical diplopia from inferior rectus restriction was most common (16 cases).
- Estimated risk of non-transient diplopia: 2.6 per 1000 cataract procedures (95% CI 1.9-4.7).
Conclusions:
- Patients require counseling regarding diplopia risk after cataract surgery with regional anesthesia.
- Treatment options include prisms, strabismus surgery, or both.