Spontaneous Evolution of Dissociated Vertical Deviation (DVD) Diagnosed before Horizontal Surgery for Congenital Esotropia

Abstract

We studied retrospectively, 52 patients with congenital esotropia and DVD, who had undergone surgery for esotropia, in order to evaluate the subsequent evolution of DVD and to identify possible predictive factors for a good or poor result. DVD was present in 85% of the esotropia cases before age 2 years, when the horizontal surgery is usually done. In most cases (85%), the DVD was of small magnitude, symmetrical (92%) and compensated (67%) and its correction was not indicated at the time. After horizontal surgery, asymmetry and decompensation increased and DVD surgery was recommended in 48% of the cases. Of the DVD characteristics prior to horizontal surgery, only decompensation was predictive of the further need for correction.

After esotropia surgery, no correlation was found between DVD decompensation and the state of horizontal alignment. However, the group who had DVD surgery was significantly more likely to have an “A” syndrome.

• dissociated vertical deviation (DVD)
• congenital esotropia
• “A” and “V” patterns