Mohamed Mostafa Kamel Diab
Ain Shams University
Egypt
Title: Prospective comparative study for various treatment modalities of dissociated vertical deviation without inferior oblique over-action
Biography
Biography: Mohamed Mostafa Kamel Diab
Abstract
Introduction: Dissociated vertical deviation (DVD) is a poorly understood vertical deviation which may remain latent (compensated) or manifest (decompensated). The deviation may be symmetrical or asymmetrical Objective: we compare 3 different surgical approaches in patients with DVD without IO over-action. Methods: This is prospective study include 48 consecutive patients with dissociated vertical deviation without inferior oblique overaction subdivided into three groups, 16 patients each Group I patients was subjected to bilateral inferior rectus tucking (plication), and Group II patients were subjected to combined bilateral superior rectus recession and Faden procedure (posterior fixation), lastly Group III bilateral superior rectus recession is the procedure for management. Results: It was found that DVD had significantly improved in all cases of group inferior rectus tucking with correct11±3pd of vertical deviation and 4±2pd of asymmetry with exception one patient needed retucking of unilateral IR for residual manifest DVD. GroupSR Faden procedure revealed moderately improved DVD with correct 9±2pd of vertical deviation 2±2pd of asymmetry with 4 patients needed resection of unilateral IR for residual manifest DVD. Group SR recession corrected to10±3pd of vertical deviation and 3±1pd of asymmetry. Conclusion: Various treatment modalities as a primary procedure for management of dissociated vertical deviation without inferior oblique overaction revealed still superior rectus recession combined with faden procedure is the best line of treatment nevertheless inferior rectus tucking procedure is safe easy respectable substitute, further studies is recommended in this field.
