Eye Fixation in Patients with Dissociated Vertical Diviation

PURPOSE: To clinically determine the proportion of people with a fixed dissociating eye in patients with dissociated vertical deviation (DVD). METHODS: Medical records of 86 patients diagnosed with DVD in our department of ophthalmology from 2001 to November 2011 were retrospectively analyzed. RESULTS: Of the 71 patients, 25 (35.21%) showed a higher degree of dissociation in the fixating eye, 26 (36.62%) had higher dissociation in the non-fixating eye; 20 of 25 patients with a higher level of dissociation in the fixating eye and 22 of 26 patients with a higher level of dissociation in the non-fixating eye received surgical correction for DVD, such as superior rectus muscle recession or inferior oblique muscle anterior transposition. CONCLUSIONS: In DVD, the proportion of patients showing a higher level of dissociation in the fixating eye was significant. Patients with DVD require thorough evaluation; measurement of the level of dissociation and determination of the fixating eye is beneficial for management and surgical intervention.

The Vertical Effect of Anterior Transposition of the Inferior Oblique Muscle for DVD with IOOA

Anterior transposition(AT) of inferior oblique muscle is an effective method to treat dissociated vertical deviation(DVD) with inferior oblique overaction(IOOA). We evaulated the clinical results of the AT and the correlation between preoperative conditions(DVD, IOOA) and postoperative vertical correction. The results was that the amount of anterior transposition was related with that of postoperative vertical correction, which was determined by the amount of preoperative DVD.

The Effect of Recession of Superior Rectus Muscle Combined with Anterior Transposition of the Inferior Oblique Muscle for Dissociated Vertical Deviation

The authors studied the effect of recession of superior rectus muscle combined with anterior transposition of the inferior oblique muscle for DVD. Superior rectus muscle was tecessed by 4.0-4.5mm combined with antetior transposition of IOM on 26 eyes in 16 patients with 15 +/- 25 delta DVD from March 1991 to September 1995. In all cases we have done transposition of the IOM to just temporal insertion of IRM. The eyes, which have the amount of DVD were less than 20 delta, received 4.0mm recession of SRM, the ones and which have the amount of DVD were more than 20 delta, received 4.5mm recession of SRM. Averaged reduction of DVD in 4.0mm group was 14.5 delta, and in 4.5mm group was 17.6 delta. As for post operative complication, only mild upgaze limitation was abserved in all cases. Recession of SRM combined with anterior transposition of IOM can correct moderate degree of dissociated vertical deviation and this method is relatively simple than other procedure.