Wydanie 4/2009

Nabyte rozbicie centralnej fuzji wywołane długo trwającą sensoryczną deprywacją

Acquired Central Fusion Disruption Evoked by Long-term Sensoric Deprivation

Anna Broniarczyk-Loba1, Elżbieta Oczkowska2, Piotr Loba3, Olimpia Nowakowska1

1 Zakład Patofizjologii Widzenia Obuocznego i Leczenia Zeza I Katedry Chorób Oczu Uniwersytetu Medycznego w Łodzi
  Kierownik: dr hab. n. med. Anna Broniarczyk-Loba
2 NSZOZ Centrum Medyczne VISUS w Starachowicach
  Dyrektor: dr n. med. Alicja Dębicka
3 Klinika Chorób Oczu I Katedry Chorób Oczu Uniwersytetu Medycznego w Łodzi
  Kierownik: prof. dr hab. n. med. Wojciech Omulecki

Summary: Background: Intractable diplopia after secondary intraocular lens (IOL) implantation may appear after surgery for unilateral traumatic cataract and long-term uncorrected aphakia. It is a result of an acquired central fusion disruption. It?s very disturbing for the patient and very difficult to diagnose and treat. Purpose: To present a patient with acquired central fusion disruption and intractable diplopia after secondary IOL implantation. Case report: A case of 25 year-old woman who underwent unilateral traumatic cataract surgery without artificial lens implantation. Over the long period of uncorrected aphakia she had developed a secondary convergent squint in the operated eye and subsequent diplopia. After a secondary IOL implantation, diplopia had increased. Prism correction has brought no relief. Due to that fact we have diagnosed intractable diplopia and the patient was treated with monovision: full correction of the refractive error in the healthy eye and lowering of the visual acuity in the eye after secondary IOL implantation. Conclusions: Secondary strabismus that appears in patients with a long-term unilateral cataract or uncorrected aphakia is a sign of fusion loss and increases the risk of postoperative intractable diplopia. Before the secondary intraocular lens implantation, binocular vision examination should be performed with concurrent contact lens correction of the aphakic eye. The lack of fusion or suppression is a contraindication to secondary artificial lens implantation.

Słowa kluczowe: centralne rozbicie fuzji, nietolerowane dwojenie, zaćma pourazowa, wszczep wtórny.

Keywords: central fusion disruption, intractable diplopia, traumatic cataract, secondary lens implantation.


powrót

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