This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (9)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Laser Surgery  • Refractive Surgery  • Alert me on articles by topic

Occurrence and Prevention

Burton J. Kushner, MD; Lionel Kowal, FRANZCO

Arch Ophthalmol. 2003;121:315-321.

Objectives  To report the occurrence of persistent diplopia manifesting after refractive surgery, to describe the different causes of this complication, to provide risk stratification for its occurrence, and to outline minimal screening techniques for its prevention.

Methods  A retrospective medical record review of patients seen in 2 private strabismus practices who experienced persistent diplopia after refractive surgery.

Results  A total of 28 patients were identified who met the inclusion criteria. The causes of postoperative diplopia could be traced to 1 of 5 mechanisms. These included technical problems, prior need of prisms, aniseikonia, iatrogenic monovision, and improper control of accommodation in patients with strabismus. The recommended screening techniques would have identified all patients in this series as being at risk for postoperative diplopia with the exception of those in whom technical problems were responsible.

Conclusions  Diplopia can become manifest after refractive surgery. With proper attention paid to risk stratification and recommended screening criteria, the incidence of this complication can be minimized.

From the Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison (Dr Kushner); the Department of Ophthalmology, University of Melbourne, Melbourne, and the Royal Victorian Eye and Ear Hospital, East Melbourne, Australia (Dr Kowal). Drs Kushner and Kowal have no relevant financial interest in this article.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Improved Binocularity After Laser In Situ Keratomileusis
Wasserman and McCoy
Arch Ophthalmol 2007;125:1293-1294.
FULL TEXT  

Effect of refractive surgery on binocular vision and ocular alignment in patients with manifest or intermittent strabismus
Godts et al.
Br. J. Ophthalmol. 2006;90:1410-1413.
ABSTRACT | FULL TEXT  

Perspective on strabismus, 2006.
Kushner
Arch Ophthalmol 2006;124:1321-1326.
ABSTRACT | FULL TEXT