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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.
References
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Figure 1.
Relationship between the amount of corrected DVD and the amount of superior rectus re-recession.* DVD=dissociated vertical deviation †PD=prism diopters.
Table 1.
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 | |
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