Diplopia as a complication of laser <i>in situ</i> keratomileusis surgery

Yap, Eng‐Yiat; Kowal, Lionel

doi:10.1046/j.1442-9071.2001.00418.x

Cited by 30 publications

(24 citation statements)

References 10 publications

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“…Only a few reports on disturbance of the binocular vision after refractive surgery exist (Godts et al, 2004;Godts, Trau, & Tassignon, 2006;Kowal, Battu, & Kushner, 2005;Kushner & Kowal, 2003;Schuler, Silverberg, Beade, & Moadel, 1999;Snir, Kremer, Weinberger, Sherf, & Axer-Siegel, 2003;Sugar et al, 2002;Yap & Kowal, 2001). Even though this is a small number of reports, they are well documented.…”

Section: Managementmentioning

confidence: 96%

“…According to Schuler et al (1999) and Kowal et al (2005) the anisometropia is too small to be a factor of the decompensation, though he might have had very fragile binocular control. Vertical phorias can lead to decentering of the optic zone during treatment (Godts et al, 2004;Yap & Kowal, 2001). Yap and Kowal described in 2001 how the laser could grind in a prism to the cornea.…”

Section: Managementmentioning

confidence: 99%

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Binocular decompensation and diplopia after refractive laser surgery

Vikesdal¹,

Jeber²

2011

Scand J Optom Vis Sci

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An increasing number of people undergo refractive surgery, and even if the refractive result after surgery is perfect, the outcome is not always successful. Decompensation of binocular vision anomalies is rarely mentioned in reports considering the outcome of refractive surgery. This report presents 4 cases with binocular vision problems after refractive laser surgery. The patients were referred to the eye department of a Norwegian hospital after having received refractive laser surgery. All patients were male adults. For all patients the reason for referral was intermittent or constant binocular diplopia. Examinations were performed according to standard procedures of the hospital eye department. Two patients were diagnosed with decompensated esodeviations; they both had a history of treatment for accommodative esotropia. One patient had unstable binocular vision of unknown cause, and one had a decompensated congenital trochlear nerve paresis. Some binocular vision problems can be foreseen with proper evaluation before surgery. A thorough history and binocular evaluation are recommended before initiating refractive laser surgery.

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Section: Managementmentioning

confidence: 96%

Section: Managementmentioning

confidence: 99%

Binocular decompensation and diplopia after refractive laser surgery

Vikesdal¹,

Jeber²

2011

Scand J Optom Vis Sci

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“…Some studies have described cases with postoperative diplopia retrospectively, or included a pre-selected population with various manifest strabismus. [7][8][9][10][11][12][13][14][15]18 Moreover, the impact of myopic refractive surgery on exodeviation has been reported to vary among reports. 2,4,6,18 We identified that corneal refractive surgery for low to moderate myopia in general did not appear to have an impact on ocular alignment.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,18,19 In contrast, there were some case reports with decompensation of exodeviation after laser surgery. 8,11,14,15 To address this, we have performed a prospective study to determine whether myopic keratorefractive surgery affects ocular alignment.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6] Conversely, although 10-year follow-ups have demonstrated that the technique is safe and predictable, 1 refractive surgery can cause strabismus and binocular diplopia. 2,[7][8][9][10][11][12][13][14][15] Patients with preexisting strabismus or anisometropiacausing aniseikonia, and those hoping to achieve monovision are at higher risk for postoperative strabismus and diplopia. 7 Therefore, refractive surgery might be a means of treatment for strabismus and a cause of strabismus.…”

Section: Introductionmentioning

confidence: 99%

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Impact of laser refractive surgery on ocular alignment in myopic patients

Chung

Kim

Moon

et al. 2014

Eye

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Purpose To evaluate the impact of myopic keratorefractive surgery on ocular alignment. Methods This prospective study included 194 eyes of 97 myopic patients undergoing laser refractive surgery. All patients received a complete ophthalmic examination with particular attention to ocular alignment before and 3 months after surgery. Results Patients with a mean age of 26.6 years and a mean refractive error of À 4.83 diopters (D) myopia were treated. Asymptomatic ocular misalignment was present preoperatively in 46 (47%) patients: a small-angle heterophoria (1-8 prism diopters, PD) in 36%; and a large-angle heterophoria (48 PD)/heterotropia in 11%. Postoperatively, the change in angles of 10 PD or greater occurred in 3% for distance and 6% for near fixation: in 7% of the patients with orthophoria, in 3% of those with a small-angle heterophoria, and in 18% of those with a large-angle heterophoria/heterotropia. No patient developed diplopia. The preoperative magnitude of myopia or postoperative refractive status was not related to the change in ocular alignment. The higher anisometropia was associated with a decrease in deviation (P ¼ 0.041 for distance and P ¼ 0.002 for near fixation), whereas the further near point of convergence tended to be related with an increase in near deviation (P ¼ 0.055). Conclusions Myopic refractive surgery may cause a change in ocular alignment, especially in cases with a large-angle heterophoria/heterotropia. There is also a chance of improvement of misalignment in patients with anisometropia.

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Diplopia After Refractive Surgery

Kushner

Kowal²

2003

Arch Ophthalmol

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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, anisei-konia, 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.

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Diplopia as a complication of laser in situ keratomileusis surgery

Cited by 30 publications

References 10 publications

Binocular decompensation and diplopia after refractive laser surgery

Binocular decompensation and diplopia after refractive laser surgery

Impact of laser refractive surgery on ocular alignment in myopic patients

Diplopia After Refractive Surgery

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