A problem! Now a solution?

Ophthalmologists are, and should be, proud of the advances in cataract surgery and aphakic correction that have occurred over the past two decades. Today, cataract surgery is considered one of the most successful surgical procedures performed throughout the world. The resulting quality of vision is usually excellent and the complication rate reasonably low. One postoperative complication, diplopia, has been a subject of intense scrutiny of late.^1–6 Although multiple causes of diplopia after cataract surgery have been described, most recent studies have emphasised the problem of extraocular muscle toxicity resulting from direct injection with a local anaesthetic at the time of surgery.^1–6 Han et al⁷ reported a series of patients with postoperative diplopic after cataract surgery. The authors concluded that 50% of the cases were associated with either direct trauma or anaesthetic myotoxicity to the extraocular muscles. It is noteworthy that they emphasised that overactions of the injured muscles were much more common than underactions. The only …