Dissociated Vertical Deviation after Correction of Infantile Esotropia.

Kim, Jang Hoon; Kim, Kyong Hwan; Cho, Yoon Ae

Original Article

Journal of the Korean Ophthalmological Society 1997;38(8):1451-1457.
Published online August 1, 1997.

Dissociated Vertical Deviation after Correction of Infantile Esotropia.

Jang Hoon Kim, Kyong Hwan Kim, Yoon Ae Cho

¹Department of Ophthalmology, Capital Armed Forces General Hospital, Seoul, Korea.
²Department of Ophthalmology, College of medicine, Korea University, Seoul, Korea.

유아내사시 수술후 발생하는 해리수직편위

김장훈(Jang Hoon Kim),김경환(Kyong Hwan Kim),조윤애(Yoon Ae Cho)

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.

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