M. Snir et al., Combined resection and anterior transposition of the inferior oblique muscle for asymmetric double dissociated vertical deviation, OPHTHALMOL, 106(12), 1999, pp. 2372-2376
Objective: To evaluate the efficacy of combined monocular resection and bil
ateral anterior transposition of the inferior oblique (IO) muscle for asymm
etric double dissociated vertical deviation (DVD).
Design: Nonrandomized, comparative clinical trial.
Participants: Twelve patients with asymmetric DVD and coexisting unequal IO
overaction (IOOA),
Intervention: Six consecutive patients underwent combined graded monocular
resection and bilateral anterior transposition of the IO muscle and six con
secutive historical control patients underwent equal anteriorization of the
IO muscle.
Main Outcome Measures: Between-group comparison of the postoperative vertic
al deviation and reduction in IOOA.
Results: The mean difference of the asymmetric DVD in the primary position
was reduced from 13.3 +/- 4.8 prism diopters (PD) to 2.2 +/- 1.8 PD in the
study group (P = 0.001) and from 13.3 +/- 4.0 PD to 10.2 +/- 3.1 PD in the
control group (P = 0.003). The difference in improvement between the groups
was statistically significant (P 0.004). The IOOA was significantly reduce
d in both groups,
Conclusions: Bilateral IO anteriorization with monocular-graded IO resectio
n should be considered as the treatment of choice in patients with asymmetr
ic DVD with IOOA.