J Korean Ophthalmol Soc.  1997 Aug;38(8):1451-1457.

Dissociated Vertical Deviation after Correction of Infantile Esotropia

• Kim JH
• Kim KH
• Cho YA

Abstract

Dissociated vrtical deviation(DVD) is frequently associated with infantile esotropia. It is hard to find DVD before surgery for esodeviation, and usually found after surgery. We studied the occurrence of DVD in 176 patients who had had horizontal rectus muscle surgery for the correction of infantile esotropia and followed up for 6 months or more. DVD was seen in 78 patients(44.3%), preoperatively in 27 patients(34.6%) and postoperatively in 51 patients(65.4%). Among 51 patients with DVD after surgery, DVD occurred in 24.0% of patients with preoperative angle of esodeviation less than 50 PD and in 44.6% of patients with preoperative angle of esodeviation more than 51 PD(P<0.01). Most of them(25 of 51 patients) developed DVD within 6 months after esodeviation surgery, however, 12 patients were noted to develop even after 2 years. This shows that we need long term follow-up for the detection of DVD. The occurrence of DVD was not influenced by the time of surgery for esodeviation(P>0.05). Inferior oblique overaction(IOOA) was accompanied with DVD in 71.8% and occurred without DVD in 28.6%. This study revealed postoperative DVD developed more in large angle esotropia such as deviation angle greater than 51 PD, and IOOA was frequently accompanied. The result suggests that in large angle infantile esotropia with mild IOOA and DVD or fundus extorsion we may need the preventive correction of DVD and IOOA.

Keyword

After surgery; Infantile esotropia; Dissociated vertical deviation, Large eso angle more than 51 PD, Inferior oblique overaction

MeSH Terms

Esotropia*
Follow-Up Studies
Humans