The Effect of Unilateral Superior Rectus Recession for Dissociated Vertical Deviation (DVD)

PURPOSE: This study analyzed the outcome of unilateral superior rectus recession in patients with asymmetrical dissociated vertical deviation (DVD) in terms of effectiveness and influence on the fellow eye. METHODS: Medical records of 40 patients (40 eyes) who had undergone unilateral superior rectus recession for the treatment of asymmetrical DVD were retrospectively reviewed from February 1993 to March 2009. The minimum follow-up period was 1 year after the operation. RESULTS: The overall success rate in the operated eye was 97.5% at 12 months and 90% at the last follow-up. However, a DVD larger than 10 PD developed in the fellow eye in 20% (8) of the patients. In patients who preoperatively had DVD in their fellow eyes, 50% developed DVD postoperatively in their fellow eyes. In patients who preoperatively did not have DVD in their fellow eyes, 14.7% developed DVD postoperatively in their fellow eyes. Furthermore, the angle of the DVD in the fellow eye increased with the surgical dosage. CONCLUSIONS: Unilateral SR recession is effective in patients with asymmetrical DVD. However, a high incidence rate of DVD in the fellow eye should be considered, especially when preoperatively there is a small DVD in the fellow eye or a large DVD angle in the operated eye, whenever monocular superior rectus recession surgery is performed.

The Effect of 9 mm, 7 mm Bilateral Superior Rectus Recession for Bilateral Dissociated Vertical Deviation

PURPOSE: To evaluate the effect of 9 mm and 7 mm bilateral recession of the superior rectus muscle in patients with bilateral dissociated vertical deviation (DVD) who had a deviation difference between the non-fixing and fixing eyes of less than 8PD. METHODS: The subjects were chosen from the patients who visited our hospital for DVD between January 2001 and November 2003. We reviewed the surgical records of 19 patients who had undergone 9 mm recession of superior rectus muscle in the non-fixing eye and 7 mm in fixing eye, and who had been followed up for at least 6 months. RESULTS: A residual DVD less than 8PD was regarded as successful. The overall success rate was 73.7%. The success rate of 10~14PD preoperative deviation of the non-fixing eye was 80.0%, and that of 15~19PD preoperative deviation of the non-fixing eye was 75.0%. However, the success rate was 66.7% in recession for the deviation over 20PD. CONCLUSIONS: Bilateral recession of 9 mm and 7 mm of the superior rectus muscle was effective for bilateral DVD in which the deviation difference of the non-fixing eye and fixing eyes was less than 8PD.

The Surgical Results According to the Amount of Superior Rectus Recession for Dissociated Vertical DeviationDVD

To evaluate the surgical results of superior rectus recession with different amount according to the degree of eyeball deviation.We reviewed the surgical records of 36 eyes in 23 patients who had undergone superior rectus recession and followed up for at least 6 months.Patients were divided into 3 groups according to the degree of deviation : Group 1[8-10PD, 4.0 mm recession], Group 2[11-20PD, 6.0 mmrecession], Group 3[21PD or greater, 8.0 mmrecession].Five PD or less after operation was regarded as acceptable. The success rate of Group 1 was 86.6%at the 6th month, 87.5% at the 12th month, and 83.8%at the 24th onth, respectively.In group 2 those were 87.5%, 75%, and 80%, respectively.In group 3 those were 60%, 50%, and 50%, respectively.The overall success rate as 83.3%at the 6th month, 75% at the 12th month, 75%at the 24th month.These results indicate that superior rectus recession with the different amount according to the degree of eyeball deviation is effective for the deviation under 20PD but not over 21PD.

The Effect of Superior Rectus Recession for Dissociated Vertical Deviation(DVD)

Dissociated vertical deviation(DVD) is a peculiar clinical entity consisting of an upward and extortional drift of a nonfixating eye. Many different surgical procedures have been advocated for its treatment, but the best approach is still debated. The authors performed superior rectus recession for treatment of DVD in 13 eyes of 8 patients. All patients were followed up for average 15 months after operation. In the vast majority cases, unilateral or bilateral superior rectus recession of graded amounts(7-8 mm) was performed. The amount of preoperative DVD was ranged from 10 to 25 delta and the mean effect of surgery was 11 delta After operation, 46% of the eyes were aligned within good to excellent categories(0-9 prism diopters), and 12 of 13 eyes within fair to excellent results(0-14 prism diopters).

The Effect of Superior Rectus Recession for Dissociated Vertical Deviation (DVD)

Dissociated vertical deviation (DVD) is a peculiar clinical entity consisting of an upward and extortional drift of a nonfixating eye. Many different surgical procedures have been advocated for its treatment, but the best approach is still debated. The authors performed superior rectus recession for treatment of DVD in 13 eyes of 8 patients. All patients were followed up for average 15 months after operation. In the vast majority cases, unilateral or bilateral superior rectus recession of graded amounts (7-8mm) was performed. The amount of preoperative DVD was ranged from 10 to 25.6. and the mean effect of surgery was 11 delta. After operation, 46% of the eyes were aligned within good to excellent categories (0-9 prism diopters), and 12 of 13 eyes within fair to excellent results (0-14 prism diopters).