Treatment of residual dissociated vertical deviation with inferior rectus resection.

The effectiveness of an ipsilateral 4-millimeter resection of the inferior rectus muscle was evaluated as a treatment of recurrent dissociated vertical deviation. Thirty-six patients who had an unsatisfactory outcome after 7- to 9-millimeter recession of the superior rectus muscle had an ipsilateral inferior rectus muscle resection. The dissociated vertical deviation was fully corrected in 18 patients and improved in 15 patients. Only three patients (8%) had an unsatisfactory result. Multivariate analysis of four preoperative features including the amplitude of the dissociated deviation, the age at diagnosis, the age at surgery, and the degree of amblyopia failed to define any factors that could predict surgical success.