title: [Vertical diplopia after cataract operation].
abstract: OBJECTIVE
  Presentation and analysis of patients with vertical diplopia appearing after cataract surgery in retrobulbar anesthesia.
  
  
  METHODS
  Between 1990 and 1998 9 Patients with vertical diplopia following cataract surgery in retrobulbar anesthesia were studied in our Orthoptic Department. Each patient had complete orthoptic examination with Hess-screen-test. Additionally, some patients underwent neuroradiologic imaging and forced-duction testing.
  
  
  RESULTS
  We subdivided the patients in a group of 4 patients with hypertropia and of 5 patients with hypotropia of the operated eye. All hypotropias were left-sided. Seven patients showed an overaction of the involved muscle without regression. Seven patients underwent surgery of a vertical muscle. Only 1 patient needed prismatic therapy postoperatively. The other 2 non-operated patients were satisfied with prisms alone.
  
  
  CONCLUSIONS
  The proposed pathogenesis of vertical diplopia in these cases is fibrosis and contracture of the injured muscle, which could be due to anesthetic myotoxicity after direct injection into the muscle or to an intramuscular hemorrhage. On the other hand hypertropia could be a result of placement of bridle sutures. We discuss prevention and therapy of such complications.
authors.affiliation: Augenklinik, Kantonsspital, Schweiz.
authors.forename: S
authors.initials: S
authors.lastname: Schacher
authors.forename: M
authors.initials: M
authors.lastname: Lüthi
authors.forename: I
authors.initials: I
authors.lastname: Schipper
mesh_terms: D000368:Aged; D000777:Anesthetics / Q000009:adverse effects*; D002387:Cataract Extraction / Q000009:adverse effects*; D004172:Diplopia / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D013285:Strabismus / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics
vernacular_title: Vertikale Diplopie nach Kataraktoperationen.