Department of Pediatric Ophthalmology, Wills Eye Institute, Philadelphia, PA 19107, USA.
Curr Opin Ophthalmol. 2010 Sep;21(5):341-4. doi: 10.1097/ICU.0b013e32833bd850.
The purpose of this article is to report the incidence and cause of diplopia following cataract surgery and laser in-situ keratomileusis (LASIK).
Ocular misalignment following cataract extraction with retrobulbar anesthesia has an incidence of approximately 7%. Diplopia ranges in this group of patients from 0.23 to 0.98%. The incidence of ocular misalignment decreases with topical anesthesia for cataract extraction to 5%, and diplopia occurs with an incidence of 0.21-0%. Although there are small case series, the incidence of diplopia following LASIK has not been reported. The causes of diplopia following cataract extraction and LASIK include decompensation of pre-existing strabismus, new-onset accommodative esotropia, concurrent onset of systemic disease, disruption of central fusion, and monocular diplopia. The leading cause for diplopia following retrobulbar anesthesia for cataract extraction is extraocular muscle paresis/restriction and is unique to this type of procedure. In cases of topical anesthesia for cataract extraction and for LASIK procedures, the leading cause of diplopia is decompensation of pre-existing strabismus.
Detailed history and evaluation for pre-existing strabismus can dramatically decrease the incidence of unexpected diplopia following refractive procedures.
本文旨在报告白内障手术后和激光原位角膜磨镶术（LASIK）后复视的发生率和原因。
球后麻醉白内障摘除术后眼球错位的发生率约为 7%。在这组患者中，斜视的范围为 0.23 至 0.98%。随着白内障摘除术的局部麻醉，眼球错位的发生率降至 5%，斜视的发生率为 0.21-0%。虽然有一些小的病例系列，但尚未报道 LASIK 后复视的发生率。白内障摘除术和 LASIK 术后复视的原因包括：先前斜视的代偿失调、新发调节性内斜视、同时发生的系统性疾病、中枢融合中断和单眼复视。球后麻醉白内障摘除术后复视的主要原因是眼外肌麻痹/限制，这是这种手术类型所特有的。在白内障摘除术和 LASIK 手术中，局部麻醉的情况下，斜视的主要原因是先前存在的斜视的代偿失调。
详细的斜视病史和评估可以显著降低屈光手术后意外发生复视的几率。
