Relationship of dissociated vertical deviation and the timing of initial surgery for congenital esotropia.
OBJECTIVE
To clarify the incidence of dissociated vertical deviation (DVD) among patients with congenital esotropia and to identify any relationship between the time when patients undergo their initial strabismus surgery and the time when they may subsequently have DVD develop.


METHODS
Noncomparative case series.


METHODS
One hundred five consecutive patients undergoing surgery for congenital esotropia over a 10-year period.


METHODS
All patients underwent bimedial rectus recession before 24 months of age.


METHODS
Patients were followed postoperatively to note the age at onset of clinically evident DVD.


RESULTS
By 6 years of age, 92% of available patients had DVD. The mean age at onset was 2.81 +/- 1.37 years. There was no significant difference between patients surgically aligned before 6 months of age compared with those aligned between 6 and 12 or 12 and 24 months of age.


CONCLUSIONS
DVD occurs in almost all patients with surgically treated congenital esotropia, and its development is unrelated to the timing of surgical intervention during the first 24 months of life.
Indiana University School of Medicine, Department of Ophthalmology, Indianapolis, Indiana 46202-5175, USA.
D E
DE
Neely
E M
EM
Helveston
D D
DD
Thuente
D A
DA
Plager
D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D015835:Ocular Motility Disorders / Q000503:physiopathology*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D015348:Vision, Binocular