Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation
Objectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD). Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had undergone bilateral superior rectus (SR) rece...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2014-03-01
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| Series: | Türk Oftalmoloji Dergisi |
| Subjects: | |
| Online Access: | http://www.oftalmoloji.org/article_2363/Outcomes-Of-Surgical-Treatment-In-Cases-Of-Dissociated-Vertical-Deviation |
| _version_ | 1828027652790812672 |
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| author | Serpil Akar Şenol Sabancı Birsen Gökyiğit Çiğdem Altan Pelin Kaynak Ali Eren Ahmet Demirok |
| author_facet | Serpil Akar Şenol Sabancı Birsen Gökyiğit Çiğdem Altan Pelin Kaynak Ali Eren Ahmet Demirok |
| author_sort | Serpil Akar |
| collection | DOAJ |
| description | Objectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD).
Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had
undergone bilateral superior rectus (SR) recessions (Group 1), bilateral SR recession with posterior fixation sutures (Group 2), or bilateral
inferior oblique (IO) anterior transposition surgery (Group 3) for treatment of DVD. Nineteen patients underwent secondary procedures
(SR weakening or IO anterior transposition) because of unsatisfactory results. The amount of the DVD in primary position before and
after surgery, postoperative success ratios, and probable complications were evaluated. The Wilcoxon signed ranks test and chi-squared
test were used for statistical evaluations.
Results: In 69% of the 32 eyes in group 1, 65% of the 20 eyes in group 2, and 79% of the 42 eyes in group 3, satisfactory control of
the DVD in primary position was achieved. All eyes undergoing both SR weakening and IO anterior transposition had a residual DVD
of less than 5 prism diopters (pd). Of the total of 94 eyes, in 26 (89.6%) of 29 eyes that had a preoperative DVD angle of more than 15
pd [ten eyes from group 1, seven eyes from group 2, and nine eyes from group 3], the residual DVD angle after surgery was more than
5 pd. However, in the 65 eyes with preoperative DVD of 15 pd or less (21from Group 1, 12 from Group 2, and 32 from Group 3), the
residual DVD angle after the operation was less than 5 pd. Two eyes of 2 patients had -1 limitation to elevation after surgery.
Conclusion: Only IO anterior transposition or SR weakening surgery appear to be a successful surgical approaches in the management
of patients with mild- and moderate-angle (≤15 pd) DVD. Weakening both the SR and IO muscles yield a greater success in the
management of patients with large-angle (>15 pd) DVD. (Turk J Ophthalmol 2014; 44: 132-7) |
| first_indexed | 2024-04-10T13:38:52Z |
| format | Article |
| id | doaj.art-597268e8f1d04266a28fd7304c6db547 |
| institution | Directory Open Access Journal |
| issn | 1300-0659 2147-2661 |
| language | English |
| last_indexed | 2024-04-10T13:38:52Z |
| publishDate | 2014-03-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Oftalmoloji Dergisi |
| spelling | doaj.art-597268e8f1d04266a28fd7304c6db5472023-02-15T16:11:14ZengGalenos YayineviTürk Oftalmoloji Dergisi1300-06592147-26612014-03-0144213213710.4274/tjo.78045Outcomes of Surgical Treatment in Cases of Dissociated Vertical DeviationSerpil Akar0Şenol Sabancı1Birsen Gökyiğit2Çiğdem Altan3Pelin Kaynak4Ali Eren5Ahmet Demirok6Prof. Dr. N. Reşat Belger Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Şaşılık Kliniği, İstanbul, TürkiyeAğrı Devlet Hastanesi, Oftalmoloji Kliniği, Ağrı,TürkiyeProf. Dr. N. Reşat Belger Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Şaşılık Kliniği, İstanbul, TürkiyeProf. Dr. N. Reşat Belger Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Glokom Kliniği, İstanbul, TürkiyeProf. Dr. N. Reşat Belger Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Okuloplastik Cerrahi Birimi, İstanbul, TürkiyeDr. Lütfü Kırdar Kartal Eğitim ve Araştırma Hastanesi, Oftalmoloji Kliniği, İstanbul, TürkiyeProf. Dr. N. Reşat Belger Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Başhekim, İstanbul, TürkiyeObjectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD). Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had undergone bilateral superior rectus (SR) recessions (Group 1), bilateral SR recession with posterior fixation sutures (Group 2), or bilateral inferior oblique (IO) anterior transposition surgery (Group 3) for treatment of DVD. Nineteen patients underwent secondary procedures (SR weakening or IO anterior transposition) because of unsatisfactory results. The amount of the DVD in primary position before and after surgery, postoperative success ratios, and probable complications were evaluated. The Wilcoxon signed ranks test and chi-squared test were used for statistical evaluations. Results: In 69% of the 32 eyes in group 1, 65% of the 20 eyes in group 2, and 79% of the 42 eyes in group 3, satisfactory control of the DVD in primary position was achieved. All eyes undergoing both SR weakening and IO anterior transposition had a residual DVD of less than 5 prism diopters (pd). Of the total of 94 eyes, in 26 (89.6%) of 29 eyes that had a preoperative DVD angle of more than 15 pd [ten eyes from group 1, seven eyes from group 2, and nine eyes from group 3], the residual DVD angle after surgery was more than 5 pd. However, in the 65 eyes with preoperative DVD of 15 pd or less (21from Group 1, 12 from Group 2, and 32 from Group 3), the residual DVD angle after the operation was less than 5 pd. Two eyes of 2 patients had -1 limitation to elevation after surgery. Conclusion: Only IO anterior transposition or SR weakening surgery appear to be a successful surgical approaches in the management of patients with mild- and moderate-angle (≤15 pd) DVD. Weakening both the SR and IO muscles yield a greater success in the management of patients with large-angle (>15 pd) DVD. (Turk J Ophthalmol 2014; 44: 132-7)http://www.oftalmoloji.org/article_2363/Outcomes-Of-Surgical-Treatment-In-Cases-Of-Dissociated-Vertical-DeviationDissociated vertical deviationsuperior rectusrecessionposterior fixation sutureinferior obliqueanterior transposition |
| spellingShingle | Serpil Akar Şenol Sabancı Birsen Gökyiğit Çiğdem Altan Pelin Kaynak Ali Eren Ahmet Demirok Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation Türk Oftalmoloji Dergisi Dissociated vertical deviation superior rectus recession posterior fixation suture inferior oblique anterior transposition |
| title | Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation |
| title_full | Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation |
| title_fullStr | Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation |
| title_full_unstemmed | Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation |
| title_short | Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation |
| title_sort | outcomes of surgical treatment in cases of dissociated vertical deviation |
| topic | Dissociated vertical deviation superior rectus recession posterior fixation suture inferior oblique anterior transposition |
| url | http://www.oftalmoloji.org/article_2363/Outcomes-Of-Surgical-Treatment-In-Cases-Of-Dissociated-Vertical-Deviation |
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