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Updated: Nov 16, 2025

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Strabismus patterns after cataract surgery in adults.

Mirjam Johanna Rossel-Zemkouo1, Richard Bergholz1, Daniel J Salchow1

  • 1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Ophthalmology, Berlin.

Strabismus
|February 26, 2021
PubMed
Summary

New-onset diplopia after cataract surgery is linked to regional anesthesia. Vertical strabismus is common, with distinct patterns observed after left or right eye surgery.

Keywords:
anesthesia;cataract surgerydiplopiamyotoxicity;strabismus

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Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • New-onset binocular diplopia is a rare complication following cataract surgery.
  • Understanding its causes and risk factors is crucial for patient management.

Purpose of the Study:

  • To analyze the causes, risk factors, and treatment outcomes of new-onset binocular diplopia after cataract surgery.
  • To identify specific ocular alignment and motility patterns associated with this complication.

Main Methods:

  • Retrospective study of 40 consecutive adult patients experiencing new-onset diplopia post-cataract surgery.
  • Evaluation of risk factors including anesthesia type and preoperative strabismus.
  • Analysis of ocular alignment and motility patterns.

Main Results:

  • Regional anesthesia was identified as the primary risk factor (37/40 patients).
  • Vertical strabismus was prevalent (37/40 patients), with distinct patterns after left (Type 1a) and right (Type 2) eye surgery.
  • 17 patients required strabismus surgery.

Conclusions:

  • Regional anesthesia is a significant risk factor for postoperative diplopia after cataract surgery.
  • Specific patterns of vertical strabismus are associated with surgery on either the left or right eye.
  • Further investigation into strabismus patterns and management is warranted.