[Diplopia after retrobulbar anesthesia in cataract surgery--a case report]

Area of Science:

• Ophthalmology
• Surgical Complications

Background:

• Retrobulbar anesthesia is a common technique for cataract surgery.
• Complications, though rare, can significantly impact patient outcomes.

Observation:

• A patient developed homolateral hypertrophia and diplopia post-retrobulbar anesthesia for cataract surgery.
• Over months, the affected eye developed hypotrophia, indicating muscle imbalance.
• The patient underwent inferior rectus muscle recession surgery.

Findings:

• Intraoperative muscle sectioning during recession improved upward passive motility.
• Post-surgery, the patient experienced remarkable improvements in motility and visual field.
• The diplopia and hypotrophia were likely caused by inferior rectus muscle injury secondary to retrobulbar anesthesia.

Implications:

• This case highlights a potential risk associated with retrobulbar anesthesia technique.
• Avoiding injections directly along the inferior rectus muscle may prevent such complications.
• Ophthalmologists should be aware of this specific complication and modify anesthetic techniques accordingly.