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NR 10-12/2006
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Dwojenie po
wszczepieniu soczewek wewnątrzgałkowych – postępowanie
nieoperacyjne
Nonoperative treatment of
diplopia after IOL implantation
Olimpia Nowakowska, Anna Broniarczyk-Loba
Z Kliniki Chorób Oczu Uniwersytetu Medycznego w Łodzi
Kierownik: prof. dr hab. n. med. Wojciech Omulecki
Z Przyklinicznej Poradni Leczenia Zeza przy Uniwersyteckim
Szpitalu Klinicznym nr 1 im. N. Barlickiego w Łodzi
Kierownik: dr hab. n. med. Anna Broniarczyk-Loba |
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| Summary: |
Purpose: Analysis
of effects of non-operative treatment of diplopia
complicating cataract surgery with IOL implantation or
secondary IOL implantation.
Material and methods: 22 patients with diplopia
occurring after cataract surgery with IOL implantation
or secondary IOL implantation were enrolled into the
study. Only the patients who were not eligible for
surgery or declined surgical treatment, were included.
Each patient had complete ophthalmic and orthoptic
examination with Hess-screen-test and prism alternate
cover tests. Predicting factors of persistent diplopia
were determined.
Results: The therapy consisted of prism
correction in 77.3% of patients and prism with botulin
toxin injections in 9.1% of patients. In two persons
diplopia persisted due to cyclotrophia and decentration
of IOL, and these patients were eventually treated
surgically. The treatment was succesful in 72.7% of
patients in whom single vision was achieved. In 18.2% of
patients occasional diplopia was found and in 9.1% the
therapy was not effective.
Disorders precipitated by prolonged cataract – related
occlusion and uncorrected aphakia, disorders resulting
from surgical trauma to extraocular muscles (retrobulbar
or peribulbar anesthesia) and preexisting complications
of ocular alignment, all predict related persistent
diplopia after IOL implantation.
Conclusions: 1. Cataract surgery with IOL and
secondary IOL implantation should be performed before
the loss of binocular function. 2. Retrobulbar and
peribulbar anesthesia may cause surgical muscular
trauma, therefore topical anesthesia is recomended. 3.
Prism correction (with or without botulin toxin
injection) is an effective therapy. |
| Słowa kluczowe: |
podwójne widzenie,
soczewki wewnątrzgałkowe, zez. |
| Key words: |
diplopia, intraocular
lenses, strabismus. |
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