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Updated: Aug 15, 2026

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Persistent strabismus after cataract extraction
Mirjana P Dujić1, Katarina R Misailović, Milena M Kovacević
1Clinical Center Zvezdara, Department of Ophthalmology, Belgrade, Serbia and Montenegro.
Background:
Transient ocular misalignment as a complication of parabulbar and peribulbar anesthesia has already been reported in the literature. The aim of our study was to present a case of irreversible iatrogenic vertical strabismus after cataract surgery, which had to be operated on.
Methods:
Clinical and orthoptic evaluation of a female patient with vertical diplopia after phacoemulsification cataract surgery.
Results:
One week after the uneventful surgery, a 68-year-old patient complained of a sudden vertical deviation in the operated eye. The patient had not had a history of previous motility disorders. On examination, the patient showed hypertropia in the left eye of 15-20 degrees in primary position. Three and 6 months postoperatively, there was no a spontaneous improvement, while the persistent vertical deviation was 40 prism dioptres. Strabismus surgery was required 1 year after the cataract surgery.
Conclusion:
Diplopia is a complication of peribulbar anesthesia which could be persistent. The superior and inferior rectus muscle are especially vulnerable. Its occurrence may be technique--related and the incidence increases when hyaluronidase is not available.
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