Unilateral Surgery in Bilateral Asymmetrical Dissociated Vertical Deviation With Strong Preferential Fixation.

Published on Sep 1, 2021in Journal of Pediatric Ophthalmology & Strabismus1.402
· DOI :10.3928/01913913-20210708-06
Andrea Lembo14
Estimated H-index: 14
 , Massimiliano Serafino14
Estimated H-index: 14
 + 1 AuthorsPaolo Nucci28
Estimated H-index: 28
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Abstract
PURPOSE To determine the best treatment for dissociated vertical deviation (DVD). METHODS The authors investigated the postoperative results of unilateral surgery for DVD in 14 patients when the visual acuity difference between the two eyes did not result in a postoperative dominance switch. All patients underwent bilateral medial rectus recession for congenital esotropia. RESULTS With this unilateral surgical procedure, all patients showed a significant improvement of the DVD in the primary position. None of the patients developed hypotropia, anti-elevation syndrome, or inferior oblique overaction in the contralateral (dominant) eye, and no changes were observed in the contralateral eye. CONCLUSIONS Unilateral surgery for DVD in the non-dominant eye in case of strong fixation preference does not create a postoperative manifest DVD in the unoperated dominant eye. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XX-XX.].
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References16
Newest
Aug 28, 2019·BMC Ophthalmology2.21
#1Shuang-Qing WuH-Index: 1
#2Qi-Bin XuH-Index: 1
Last. Li-Wei ZhuH-Index: 2
view all 4 authors...
Background To evaluate the results of unilateral inferior oblique anterior transposition (IOAT) for markedly asymmetric dissociated vertical deviation (DVD) combined with inferior oblique over-action (IOOA).
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Aug 1, 2007·Archives of Ophthalmology
#1Burton J. Kushner (UWHC: University of Wisconsin Hospital and Clinics)H-Index: 50
Objective To describe the clinical features, etiology, and management of superior oblique tendon incarceration syndrome. Methods This series consists of all patients I treated between September 15, 1974, and March 1, 2006, for restrictive hypertropia in which the superior oblique tendon was found scarred to the superior rectus muscle insertion after prior surgery. Results Twenty eyes in 18 patients were included in this series. The mean ± SD hypertropia of the affected eye was 15.4 ± 9.0 prism d...
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Summary Background: There are several options for the treatment of dissociated vertical deviation (DVD). The most discouraging results are those cases of poor vision. The fold of the inferior rectus is presented as a therapeutic option for poor vision. Methods: Patients with spontaneous DVD and monocular poor vision were included. A maximum folding of the inferior rectus was performed only in the eye with poor vision. Evaluation of the spontaneity and magnitude of the DVD was done in the pre- an...
Jun 1, 2004·Journal of Aapos1.22
#1Erick D. BothunH-Index: 14
#2C. Gail Summers (UMN: University of Minnesota)H-Index: 32
Abstract Purpose This study analyzes the outcomes after unilateral inferior oblique anterior transposition (IOAT) for manifest dissociated vertical deviation (DVD). Methods A retrospective chart review was conducted for all patients who had unilateral or markedly asymmetric DVD, ipsilateral overaction of the inferior oblique muscle, lack of alternating fixation, and underwent unilateral IOAT surgery between March 1997 and March 2001. In each case, the bunched inferior oblique muscle was anterior...
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Aug 1, 2003·Journal of Aapos1.22
#1Mauro GoldchmitH-Index: 6
#2Sergio FelbergH-Index: 1
Last. Carlos Souza-DiasH-Index: 6
view all 3 authors...
Abstract Purpose To evaluate the correction of hypertropia in primary position with unilateral inferior oblique (IO) anterior transposition (IOAT). Methods Ten patients with idiopathic (nonparalytic, restrictive, or dissociated vertical deviation) hypertropia with marked IO overaction, who underwent unilateral IOAT, were prospectively evaluated to observe the correction of the hypertropia in primary position. No previous ocular muscle surgery had been performed. Four patients had esotropia and t...
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#1Daniel E. Neely (IU: Indiana University)H-Index: 21
#2Eugene M. Helveston (IU: Indiana University)H-Index: 33
Last. David A. Plager (IU: Indiana University)H-Index: 43
view all 4 authors...
Abstract Purpose To clarify the incidence of dissociated vertical deviation (DVD) among patients with congenital esotropia and to identify any relationship between the time when patients undergo their initial strabismus surgery and the time when they may subsequently have DVD develop. Design Noncomparative case series. Participants One hundred five consecutive patients undergoing surgery for congenital esotropia over a 10-year period. Methods All patients underwent bimedial rectus recession befo...
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#1David L. Guyton (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 34
Abstract Purpose: The etiology and mechanism of dissociated vertical deviation (DVD) are explored. Methods: In 6 young adults with DVD, the simultaneous horizontal, vertical, and torsional eye movements for both eyes were recorded by using dual-coil scleral search coils. Analysis of the simultaneous vertical and torsional movements that occurred during the DVD response identified the primary muscles acting in the vergences and versions involved. Results: Typically, both horizontal and cycloverti...
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Sep 1, 1999·Archives of Ophthalmology
#1Michael C. Brodsky (University of Arkansas for Medical Sciences)H-Index: 36
Dissociated vertical divergence (DVD) is an ocular motor disorder characterized by a slow, upward drift of 1 eye when the other eye is fixating a target. I propose that DVD is a dorsal light reflex in which asymmetrical visual input to the 2 eyes evokes a vertical divergence movement of the eyes. This primitive visuo-vestibular reflex functions as a righting response to restore vertical orientation in lower lateral-eyed animals by equalizing binocular visual input. The dorsal light reflex is sup...
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#1John P. Burke (UIHC: University of Iowa Hospitals and Clinics)H-Index: 4
#2William E. Scott (UIHC: University of Iowa Hospitals and Clinics)H-Index: 35
Last. Pamela J. Kutschke (UIHC: University of Iowa Hospitals and Clinics)H-Index: 8
view all 3 authors...
Background: Recently, anterior transposition of the inferior oblique muscle was reported to be an effective treatment for dissociated vertical deviation (DVD), but data on long-term stability have not been reported. Methods: A retrospective, longitudinal analysis of 17 consecutive patients (22 eyes) with dissociated vertical deviation and inferior oblique overaction who had an anterior transposition of the inferior oblique for significant dissociated vertical deviation and a minimum of 12 months...
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#1Mary Beth Esswein (BCM: Baylor College of Medicine)H-Index: 2
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Last. Amy G. Coburn (BCM: Baylor College of Medicine)H-Index: 1
view all 3 authors...
The effectiveness of 3- to 5-mm recession of the superior rectus muscle with and without posterior fixation sutures was compared with 7- to 9-mm superior rectus muscle recessions in 228 patients with dissociated vertical deviation. We examined the patients at intervals ranging from six months to three years, and the results were classified as corrected, improved, or failed. Superior rectus muscle recessions of 3 to 5 mm were the least successful treatment. When 3- to 5-mm recession was combined ...
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