ABSTRACT
ABSTRACT: Objective: To evaluate factors that may conduce to diplopia or decompensate a strabismus after refractive surgery. Methods: Retrospective study of 17 patients who, presented diplopia or strabismus after refractive surgery. Twelve patients were myopic, five hyperopic and 4 of them had a marked anisometropia. Average age at surgery was x 36,88 SD 8,45 (27-51) years. PRK was the refractive procedure in 3 cases, LASIK in 13 and PC IOL LASIK. Results: We could observe that all of our patients had a binocular pathology previous to the refractive surgery. After surgery 11 patients had an esophoria or esotropia, 3 exophoria or exotropia and 3 decompensated vertical deviations. Frequently, several factors worked simultaneously in the same patient as: Hypercorrected myopia, residual hyperopia, postoperative visual instability, dominance change, a marked flap decentration, and a presbiopic age. Conclusions: The most important factor to develop a diplopia or strabismus after refractive surgery is the presence of a previous binocular pathology, above all in patients close or in presbiopic age. This situation may decompensate by several factors but mostly by myopic hypercorrection, accommodative and visual factors.
