Anterior Transposition of the Inferior Oblique Muscle for Dissociated Vertical Deviation Associated with Inferior Oblique Muscle Overaction

Koo, Hweon Min; Park, Hyo Soon; Won, In Gun

Abstract

We analyzed the surgical results of 9 eyes in 7 patients who had undergone the anterior transposition of inferior oblique muscle for correction of dissociated vertical deviation(DVD) with inferior oblique overaction from April, 1990 to February, 1992. The follow up periods were at least more than 6 months. In cases of upward deviation angle were less than 16 delta, we have done transposition of the inferior oblique muscle to just temporal insertion of inferior rectus muscle, and in cases of upward deviation angle were more than 16 delta, the inferior oblique muscle was transpositioned to 1mm anterior position of the just temporal insertion of inferior rectus muscle. Average reduction of DVD in method A(5 eyes in 4 patients) was 9.2 delta, average reduction of DVD in method B(4 eyes in 3 patients) was 10.2 delta. As for postoperative complications, mild upgaze limitation was observed in all cases and one case of "V" pattern exotropia and one case of protrusion of lower eyelid were observed at extreme upgaze position. Therefore, anterior transposition of inferior oblique muscle for correction of dissociated vertical deviation(DVD) with inferior oblique overact ion can considered as a good method to remove the postoperative manifest vertical deviation.