| The Effect of Posterior Fixation Suture Combined with Recession of Superior Rectus Muscle for Dissociated Vertical Deviation. |
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Chang Bo Shim, Sang Jin Kim |
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Department of Ophthalmology, Keimyung University, School of Medicine, Daegu, Korea. |
| Dissociated Vertical Deviation 에서 상직근의 후전술을 병행한 후고정봉합술의 효과 |
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심창보(Chang Bo Shim),김상진(Sang Jin Kim) |
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| Abstract |
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Dissociated vertical deviation(DVD) is a clinical entity consisting of an up ward and extorsional drift of a nonfixating eye. This can occur spontaneously or during occlusion of that eye. The cosmetic importance of surgical management of manifest DVD has been agreed upon, but a number of different operative approaches have been cited in the literature. The surgical treatments for DVD are large recession of the superior rectus(10-16mm), resection of the inferior rect-us as much as 8mm, posterior fixation suture of the superior rectus and posterior fixation suture combined with the superior rectus recession. However, in comparing the long-term effect of recession of the superior rectus muscle, reces-sion of the superior rectus muscle combined with posterior fixation, with that of posterior fixation of the superior rectus muscle without recession, Duncan and von Noorden concluded that the best results are obtained by conventional recession of the superior rectus muscle(4 to 5mm) combined with posterior fixation of 12-15mm behind the muscle insertion. 8 eyes of 7 patients received 4mm recession of the superior rectus muscle combined with 12-15mm posterior fixation suture for the treatment of DVD. All patients were followed for postoperative period of 4 weeks to 20 months. The results were as follows: 1. The amount of preoperative DVD has ranged from 20 delta to 38 delta. 2. The amount of postoperative DVD has ranged from 0 delta to 10 delta, and the effect of that surgery has ranged from 10 delta to 33 delta, average 23 delta. 3. After operation 7 of 8 eyes were aligned, within the good to excellent categories (0-10 delta). |
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