Four Cases of Strabismus presenting after Cataract Surgery

PURPOSE: We report four cases of strabismus presenting after cataract surgery and review the previous reports. METHODS: We examined four cases with diplopia for three months or more following cataract surgery between March 2001 and February 2002 in our hospital. We reviewed our records to inquire the preoperative systemic and ophthalmologic exam included past and present medical history. Also, we performed the strabismus test such as prism and cover test, forced duction test, force generation test included CT scan, if necessary. RESULTS: Case 1, 2, 3 were performed by retrobulbar anesthesia. Case 1 showed left superior rectus muscle overaction, case 2 showed left inferior rectus muscle palsy, case 3 showed left inferior rectus muscle palsy and superior rectus muscle overaction. Case 4 showed irregular pattern of strabismus. In case 1, 2, 3, diplopia in primary position was improved after strabismus surgery. We have observed case 4 until the pattern of strabismus would be stable. CONCLUSIONS: After uneventful cataract surgery, persistent strabismus may be occurred. So the operator must explain the occurrence of strabismus to patient before surgery, and carefully perform pre and post operative strabismus test and retrobulbar anesthesia.