Surgical management of dissociated vertical deviation associated with A-pattern strabismus

Velez, Federico G.; Ela-Dalman, Noa; Velez, Guillermo

doi:10.1016/j.jaapos.2008.09.006

Cited by 16 publications

(13 citation statements)

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“…In scientific research, allowing for the mirror symmetry between the right and the left eyes, one may either use only the right or only the left eyes for a study, or use the fellow eye as a ‘control’ 5. In clinical application, this feature has been helpful, including in planning for strabismus,6 predicting refraction for cataract surgery,7 detection of anatomy abnormalities and disease diagnosis 8. High interocular symmetry may also be helpful in verifying the accuracy of binocular data, so asymmetric data may be required for remeasurement 9.…”

Section: Introductionmentioning

confidence: 99%

Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

et al. 2018

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“…It should be noted that although several other authors have recommended asymmetric DVD surgery as described above, the anterior transposition in our subjects was never anterior to the insertion of the inferior rectus muscle, unlike most other case series [3, 5, 7, 13]. Other authors have recommended adding a superior rectus recession in cases of DVD with asymmetry greater than 5 PD [16, 17], but in this case series, we have shown that asymmetric DVD is also readily treatable with asymmetric IOAT without the addition of superior rectus recession, thereby avoiding the possibility of limiting upgaze from a combined IOAT/superior rectus recession. A main advantage of asymmetric IOAT is the ability to collapse an asymmetrical DVD without the need to operate on a second muscle (such as the superior rectus).…”

Section: Discussionmentioning

confidence: 73%

Asymmetric inferior oblique anterior transposition for incomitant asymmetric dissociated vertical deviation

Pineles

Velez

2013

Graefes Arch Clin Exp Ophthalmol

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Background Inferior oblique anterior transposition (IOAT) is indicated in patients with incomitant dissociated vertical deviation (DVD) larger in adduction. In general, bilateral surgery is recommended in patients with DVD unless there is deep monocular amblyopia. The purpose of this study is to evaluate the results of asymmetric IOAT in patients with asymmetric incomitant DVD larger in adduction. Methods Retrospective chart review of the records of all patients with incomitant asymmetric DVD associated with inferior oblique (IO) overaction who underwent asymmetric IO weakening procedure. In all patients, the eye with more DVD in adduction underwent IOAT to the temporal corner of the insertion of the inferior rectus (IR) muscle, and the eye with less DVD underwent IOAT to a position 3–4 mm posterior to the insertion of the IR. No other muscles were operated simultaneously. No patient had previous surgery on any cyclovertical extracular muscle. Results Fourteen patients were included. Mean age at surgery was 10.3 ± 8.8 years (range 4–33). Primary position DVD preoperatively was 18 ± 2 PD in the eye with the larger DVD compared to 1.1 ± 1.0 PD postoperatively (p <0.0001). DVD asymmetry between the lateral gaze with the largest DVD and the lateral gaze with the smallest DVD was 9.8 ± 3.1 PD (range 5–14 PD) preoperatively vs 1.1 ± 1.0 PD (range 0–2 PD), (p < 0.0001). Ten patients had preoperative V-pattern >10 PD (24.7 ± 8.7 PD, range 12–50 PD) preoperatively vs no patients postoperatively (mean V-pattern 4.4 ± 2.0 PD), (p <0.0001). Postoperative follow up was 1.6 ± 0.7 years (range 1–3 years). Conclusion In patients with asymmetric incomitant DVD, asymmetric IOAT improves lateral incomitance without increasing the risk of antielevation, limitation in upgaze rotation, or hypertropia, or worsening the DVD in the eye with less deviation preoperatively.

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“…DVD'nin de eşlik ettiği A paterni olan şaşılık hastalarında bilateral üst rektus geriletmesinin 12 PD'nin altındaki A paternini düzeltti-ğini, 12-20 PD arası A paterninde üst rektus geriletmesi ile üst oblik zayıflatmanın kombine edilmesi gerektiğini, geniş paterni (>20 PD) olan hastalarda ise dört oblik kasının da zayıflatılması-nın gerekli olabileceğini belirtmişlerdir. 25 Serilerinde, çalışmamıza benzer şekilde en sık uygulanan cerrahi üst rektus geriletmesi olmuştur. Ancak, bizim çalışmamıza paterni olan hastalar dahil edilmemiştir.…”

Section: Gereç Ve Yöntemlerunclassified

Dissociated Vertical Deviation: Surgical Treatment and Its Results

Şekeroğlu¹,

Turan²,

Yalinbaş³

et al. 2014

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Disosiye vertikal deviasyonu (DVD) olan şaşılık hastalarında klinik özellikleri tanımlamak, cerrahi endikasyonlarını ve cerrahi zamanını belirlemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hacettepe Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Şaşılık Birimi'nde DVD'si olan, horizontal kas cerrahisi ile birlikte veya tek başına DVD'ye yönelik cerrahi yapılan ve düzenli olarak takip edilen hastaların kayıtları geriye dönük olarak tarandı. Hastaların yaşları, takip süreleri, kayma tipi, DVD miktarları (prizm dioptri, PD), uygulanan cerrahi tipi ve sonuçları değerlendi-rildi. B Bu ul lg gu ul la ar r: : Çalışmaya alınan 86 hastanın (yaş: 7,69±4,98, 1-51 yıl) 53'ü kız, 33'ü erkekti. Hastaların 53 (%61,62)'ünde ezotropya, 26 (%30,24)'sında ekzotropya mevcut iken, 7 (%8,14)'sinde belirgin horizontal kayma yoktu. Hastaların 63 (%73,26)'üne daha önce veya DVD cerrahisi ile eş zamanlı olarak horizontal şaşılıklara yönelik müdahale yapıldı. Hastaların 27 (%31,39)'sine ise DVD'ye yönelik cerrahi uygulandı. DVD cerrahisi yaşı ortalama 8,36±4,55 (2-18) yıl idi. Cerrahi uygulanmayan hastalarda ortalama DVD miktarı 8,59±4,96 (2-12) PD iken, cerrahi uygulanan hastalarda 15,66±9,19 (12-40) PD idi (p=0,008). Cerrahi uygulanan hastalarda DVD miktarında cerrahi sonrasında anlamlı azalma izlendi (6,41 ± 3,24 PD, 12-40 ve p=0,006). En sık uygulanan cerrahi üst rektus geriletmesi (15 hasta, %55,56) iken, bunu alt oblik anterotranspozisyonu (12 hasta, %44,44) izliyordu. S So on nu uç ç: : Çalışmamızda, DVD'nin farklı şaşılık tipleri ile birlikte olduğu görülmekle birlikte, en sık ezotropya ile birlikte görüldüğü, ve cerrahi ile DVD miktarında anlamlı düzelme elde edildiği saptanmıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Şaşılık; göz hareket bozuklukları A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To define the clinical characteristics, and determine the indications for surgery and surgical timing in strabismic patients with dissociated vertical deviation (DVD). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The medical records of patients with DVD who underwent surgery for DVD alone or combined with horizontal muscle surgery, and who had been followed regularly in Hacettepe University Department of Ophthalmology Strabismus Unit were retrospectively reviewed. The age, follow-up time, type of deviation, amount of deviation (prism diopters, PD) of the patients, and type and results of the surgery were evaluated. R Re es su ul lt ts s: : Of 86 patients (age: 7.69±4.98, 1-51 years), 53 were females and 33 were males. Fifty patients (61.62%) had esotropia, 26 (30.24%) had exotropia whereas seven of them (8.14%) had no manifest horizontal deviation. Sixty-three patients (73.26%) underwent an intervention for horizontal deviations before or simultaneously with DVD surgery. Of 86 patients, 27 (31.39%) underwent surgery for DVD. The mean age at surgery for DVD was 8.36±4.55 (2-18) years. The mean amount of DVD was 8.59±4.96 (2-12) PD in patients ...

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Surgical management of dissociated vertical deviation associated with A-pattern strabismus

Cited by 16 publications

References 11 publications

Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

Asymmetric inferior oblique anterior transposition for incomitant asymmetric dissociated vertical deviation

Dissociated Vertical Deviation: Surgical Treatment and Its Results

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