During the PAST several years the incidence of bothersome postoperative diplopia in some patients following otherwise uneventful and successful cataract surgery has increased. Typically, these patients show outstanding improvement in visual acuity but are troubled by persistent incapacitating vertical and, occasionally, horizontal diplopia noted during the first few postoperative days. Usually, the cataract surgeon is surprised and perplexed by these new complaints. The diplopia has no single cause; rather, a variety of different reasons accounts for these distressing strabismic problems.
The cataract surgeon is familiar with monocular causes of postoperative diplopia, such as corneal irregularities or lens decentration, as well as binocular problems related to anisometropia. In my experience, these causes for postoperative diplopia are uncommon, and a search for a true strabismic cause is frequently required.
Some patients may have previously unrecognized strabismic conditions that become manifest following visual acuity improvement, eg, patients with thyroid ophthalmopathy, especially those who
Rosenbaum AL. Strabismus Following Uncomplicated Cataract Surgery. Arch Ophthalmol. 1997;115(2):253. doi:10.1001/archopht.1997.01100150255018