Treatment methods for binocular diplopia after cataract surgery

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  • 白内障術後に両眼性複視を訴えた症例への対処法

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<p>[Purpose] We had experienced patients who showed no diplopia before surgery but complained of diplopia which was subjectively detected after cataract surgery along with visual acuity improvement. In this study, we retrospectively investigated the methods to manage such cases. </p><p>[Subjects and Methods] This study involved 24 patients (10 males and 14 females; mean age, 76 ± 8.2 years, range, 55-89 years) with binocular diplopia after cataract surgery who had visited the Department of Ophthalmology at Osaka Medical College Hospital between January 2014 and May 2017. The patients were divided into the following 3 groups: exotropia group (7 patients), esotropia group (7 patients), and vertical strabismus group (10 patients). The treatment methods used in these patients and the patients' level of satisfaction were investigated. </p><p>[Results] The most common treatment method for diplopia was prism (membrane and ground-in) prescribed for 50.0% of the subjects (14.3% in the exotropia group, 71.4% in the esotropia group, and 60.0% in the vertical strabismus group), followed by compensatory head posture (16.7%), occlusion foils (Bangerter) (8.3%), absorptive lenses for photophobia (8.3%), and monovision glasses (8.3%). After experiencing various treatment methods, 20.8% of the patients indicated that they were not satisfied with any particular treatment method. The patients' overall satisfaction was ranked in 3 levels and 66.7% of the patients were satisfied with the treatment result, 25.0% were neutral, and 8.3% were not satisfied. </p><p>[Conclusion] Although the treatment methods for binocular diplopia after cataract surgery may vary among patients and no single standard treatment can be defined, prism appears to be an option worth trying. Even provided with various treatment options, patients may not be satisfied. Nevertheless, paying careful attention to patient's complaints and helping them to deal with the inconvenience in their daily life will be necessary.</p>

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