The Effect of Unilateral Surgery in Dissociated Vertical Deviation

PURPOSE: To investigate changes in the unoperated eye of patients who underwent unilateral surgery for asymmetrical dissociated vertical deviation. METHODS: We performed superior rectus recession and inferior oblique anterior transposition in the case of asymmetrical dissociated vertical deviation, and lateral rectus recession in the case of dissociated horizontal deviation. We excluded patients having a history of previous operation on the vertical rectus muscles, oblique muscle in the unoperated eye, nystagmus, neurologic problems, and imprecise measurement of deviation angle. Changes in the unoperated eyes of 11 patients who underwent unilateral surgery to correct asymmetrical dissociated vertical deviation in the other eye, from May 2003 to April 2004 were analyzed retrospectively at 1 year postoperative. RESULTS: Not all cases of preoperative latent dissociated vertical deviation manifested such deviation in the unoperated eye postoperatively. CONCLUSIONS: Unilateral surgery is an effective treatment in patients with asymmetrical dissociated vertical deviation and does not affect the unoperated eye.

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

Dissociated vertical deviation(DVD)is a kind of vertical strabismus of an upward drift of a nonfixating eye, and requires operation when it is cosmetically unacceptable. The authors compared the results of unilateral superior rectus recession with those of bilateral recession in the treatment of DVD, and analyzed the effects and complications of the superior rectus recession. The charts of 58 patients(94 eyes)who underwent superior rectus recession for DVD were retrospectively reviewed, and minimum follow-up was 6 months after operation. In 22 patients, the recession was performed unilaterally, and in 36 patients bilaterally. Satisfactory alignment under 9 PD was obtained in 77.3%of the unilateral cases and 77.8%of the bilateral cases. DVDs developed in unoperated eye in 9 unilateral cases. Graduated superior rectus recession was a quite predictable and effective procedure in the treatment of DVD. In unilateral surgery, it is important to keep in mind that the unmasking of DVD in the fellow eye can occur, but unilateral surgery may be indicated if only when the obvious deviation is diagnosed preoperatively in one eye.

A Comparison of Clinical Results in Unilateral and Bilateral Cataract Surgerys

PURPOSE: This study compares the outcomes of unilateral cataract surgery to those of bilateral cataract surgery in patients with cataract of both eyes. METHODS: Among a total of 153 patients, 61 underwent unilateral surgery and 92 bilateral surgery. RESULTS: The unilateral and bilateral surgeries were similar in demographic and ocular characteristics including visual acuity and visual function-14, except patient-reported factor, such as trouble with vision at baseline. The patient-reported factor was more serious in bilateral surgery than in unilateral surgery. The changes of three outcomes were associated not with unilateral eye or bilateral eye surgery, but with each baseline condition. CONCLUSION: The patient-reported factors such as symptom score, trouble with vision were the significant outcomes to decide unilateral or bilateral surgery in patients with cataract of both eyes. The result of unilateral or bilateral surgery did not affect the outcomes of cataract surgery after 12 months.