JKOS Journal of the Korean Ophthalmological Society J Korean Ophthalmol Soc 0378-6471 2092-9374 Korean Ophthalmological Society 10.3341/jkos.2010.51.2.266 jkos-51-266 Original Article The Effect of Superior Rectus Re-recession for Dissociated Vertical Deviation KimSin-Uk MD 1 KimMyung-Mi MD 2 Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea Address reprint requests to Myung-Mi Kim, MD Department of Ophthalmology, Yeungnam University College of Medicine #317-1 Daemyeong 5-dong, Nam-gu, Daegu 705-717, Korea Tel: 82-53-620-3441, Fax: 82-80-623-8001, E-mail: mmk@med.yu.ac.kr 09 2010 07 09 2010 51 2 266 269 21102009 15122009 Copyright © 2010 Korean Ophthalmological Society 2010 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

When recurrent dissociated vertical deviation (DVD) is cosmetically objectionable after superior rectus recession is used to surgically treat DVD, inferior rectus resection or superior rectus re-recession should be considered. The effect of re-recession of the superior rectus was, therefore, evaluated as a treatment of recurrent DVD.

 Methods

We retrospectively reviewed the medical records of 9 eyes from 7 patients who had undergone superior rectus re-recession as a second surgery due to recurrence after superior rectus recession for DVD.

 Results

The mean follow-up period after re-recession of the superior rectus was 32.1 (22∼66) months. The preoperative mean deviation was 16.0 prism diopters (PD), and the postoperative mean deviation was 4.9PD. According to the classification of recurrent DVD by Scott, the surgical results of five eyes were excellent (0∼4PD), those of 2 eyes were good (10∼14PD), and those of 2 eyes were fair. The mean corrected DVD was 4.1PD per 1 mm recession.

 Conclusions

Postoperatively, 7 of 9 eyes (77.7%) were aligned within 9PD. In cases of recurrent DVD, superior rectus re-recession yielded satisfactory results with minimum surgery on the superior rectus. The results of this study will be helpful in deciding surgical amount of superior rectus re-recession to be performed.

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Relationship between the amount of corrected DVD and the amount of superior rectus re-recession.* DVD=dissociated vertical deviation †PD=prism diopters.

Clinical findings and surgical results in 9 eyes of 7 patients

Patient No. Laterality Age (yr) * Preop ‡ DVD (PD§1) † Postop DVD (PD) Corrected DVD Amount of previous recession (mm) Amount of re-recession (mm) Follow up (mo) ∏ Surgical result
1 OD 9 20 0 20 4 3 23 Excellent
2 OS 6 12 0 12 6 3 27 Excellent
3 OD 12 14 0 14 5 3 30 Excellent
4 OD 23 27 8 19 5 3 22 Good
5 OD 6 14 4 10 7 2 31 Excellent
OS 6 16 12 4 7 2 31 Fair
6 OD 22 12 2 10 5 4 66 Excellent
OS 22 9 10 −1 7 2 66 Fair
7 OS 19 20 8 12 7 2 26 Good
Average 13.9 16.0 4.9 11.1 2.67 32.1

Preop=preoperative

Postop=postoperative

DVD=dissociated vertical deviation

PD=prism diopters

Surgical result: classification of recurrent dissociated vertical deviation by Scott.4