title: A surgical alternative for dissociated vertical deviation based on new pathologic concepts: weakening all four oblique eye muscles. Outcome and results in 9 cases.
abstract: OBJECTIVE
  To test new and recent theories on the etiology of Dissociated Vertical Deviation (DVD) with an appropriate new alternative surgical technique.
  
  
  METHODS
  Nine patients were prospectively selected. The surgical technique used was simultaneous and symmetrical weakening of all 4 oblique eye muscles in order to reduce bilateral cyclotorsion. For analysis, "Statistical Significance" level used was p<0.05.
  
  
  RESULTS
  Mean preoperative hypertropia was 17.9 prism diopters (pd) for the right eyes (RE) and 17.7 pd for the left eyes (LE). Mean post-surgical deviation achieved was 6.44 pd for the REs and 5.78 pd for the LEs. Statistical analysis (Wilcoxon's Test) showed a p<0.02 for both eyes. In all cases, a symmetrical correction was also obtained.
  
  
  CONCLUSIONS
  The hypothesis that the manifest hypertropia seen in patients with DVD is secondary to cyclotorsion, mediated primarily by the oblique muscles, was validated by improving (reducing) the DVD by performing bilateral and symmetrical weakening of all four oblique extraocular muscles.
authors.affiliation: Ophthalmology Service, R. Gutierrez Children's Hospital, Buenos Aires, Argentina. egamio@ciudad.com.ar
authors.forename: Susana
authors.initials: S
authors.lastname: Gamio
mesh_terms: D002648:Child; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D016896:Treatment Outcome; D015348:Vision, Binocular