title: Risk factors of persistent diplopia following secondary intraocular lens implantation in patients with sensory strabismus from uncorrected monocular aphakia.
abstract: OBJECTIVE
  We aimed to compare clinical characteristics between diplopia-free and diplopia-persistent patients after successful strabismus surgery, when patients complained of diplopia following secondary intraocular lens (IOL) implantation after prolonged aphakia accompanied by sensory strabismus.
  
  
  METHODS
  Retrospective review of medical records of patients who complained of diplopia following secondary IOL placement with sensory strabismus after prolonged uncorrected monocular aphakia from isolated ocular trauma was done. We classified patients into two groups according to persistency of diplopia, 6 months after successful strabismus surgery. Clinical characteristics were compared between groups.
  
  
  RESULTS
  A total of 31 patients were included. The diplopia-persistent group showed longer duration of uncorrected aphakia (p = 0.02), less severe corneal astigmatism (p = 0.04), a smaller exodeviation angle (p = 0.02), and more frequent vertical deviation (p = 0.015), extorsion (p = 0.022) and monocular nystagmus (p = 0.028) than the diplopia-free group. In all patients in the diplopia-free group, diplopia could be eliminated prior to strabismus surgery using loose prisms in free space, whereas seven patients in the diplopia-persistent group prior to surgery could not resolve diplopia.
  
  
  CONCLUSIONS
  Our data will be helpful for ocular surgeons in determining whether to insert secondary IOL in prolonged aphakia with sensory strabismus, or whether strabismus surgery will eliminate diplopia that develops following secondary IOL placement in this situation.
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Ye Jin
authors.initials: YJ
authors.lastname: Ahn
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Shin Hae
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea. eyeshin@catholic.ac.kr.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Shin
mesh_terms: D000328:Adult; D001036:Aphakia, Postcataract / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004172:Diplopia / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D015349:Vision, Monocular / Q000502:physiology; D014792:Visual Acuity
keywords: Aphakia; Diplopia; Intraocular lens implantation