• Julio Yangüela, Juan I Gómez-Arnau, José C Martín-Rodrigo, Alfonso Andueza, Pablo Gili, Beatriz Paredes, María C Porras, Fernando González del Valle, and Alfonso Arias.
• Ophthalmology Unit, Department of Surgery, Fundación Hospital Alcorcón, c/Budapest 1, 28922 Alcorcón, Madrid, Spain. jyanguela@fhalcorcon.es
• Ophthalmology. 2004 Apr 1; 111 (4): 686-92.

ObjectiveTo compare the incidence of diplopia after topical or regional injection anesthesia in cataract surgery.Study DesignRetrospective, noncomparative interventional case series.Participants And MethodsThree thousand five hundred forty-two consecutive cataract surgeries, performed from March 1998 to December 2001, were studied.Main Outcome MeasuresIncidence and mechanisms of diplopia.ResultsTwo thousand one hundred twenty-two patients were operated under regional and 1420 under topical anesthesia. Twenty-four cases of diplopia were observed, 21 (87.5%) in the regional group and 3 (12.5%) after topical anesthesia (P = 0.005). Eleven cases (45.8%) were secondary to motility problems, all in the regional anesthesia group (P = 0.006). Eight cases (33.3%) were secondary to refractive errors or intraocular lens luxation, 5 after regional and 3 after topical anesthesia (P = 0.88). Five cases (20.8%) were secondary to fusion loss, all in the regional anesthesia group (P = 0.06).ConclusionsIn our study, topical anesthesia was associated with a lower incidence of diplopia relative to regional injection anesthesia. No cases of diplopia secondary to fusion loss or muscle damage were found after topical anesthesia surgery.

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