title: Persistent strabismus after cataract extraction.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinical Center Zvezdara, Department of Ophthalmology, Belgrade, Serbia and Montenegro.
authors.forename: Mirjana P
authors.initials: MP
authors.lastname: Dujić
authors.forename: Katarina R
authors.initials: KR
authors.lastname: Misailović
authors.forename: Milena M
authors.initials: MM
authors.lastname: Kovacević
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D004172:Diplopia / Q000209:etiology; D005260:Female; D006801:Humans; D013285:Strabismus / Q000209:etiology*