Disosiye vertikal deviasyonda cerrahi ve sonuçları

Objective: To define the clinical characteristics, and determine the indications for surgery and surgical timing in strabismic patients with dissociated vertical deviation (DVD). Material and Methods: 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. Results: 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 without surgery, and it was 15.66±9.19 (12-40) PD in patients who underwent surgery (p=0.008). The amount of DVD significantly reduced postoperatively (6.41±3.24 PD, 12-40, p=0.006). The most commonly performed surgery was the recession of superior rectus muscle in 15 patients (55.56%) followed by anterotransposition of the inferior oblique muscle in 12 patients (44.44%). Conclusion: The present study showed that DVD may be coexistent with different types of deviations, but it is frequently seen with esodeviations, and surgery may significantly reduce the amount of DVD.