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Dissociated vertical deviation: what is the most effective surgical approach?
B Lorenz1, I Raab, K P Boergen
1University Eye Clinic, Munich, Germany.
Journal of Pediatric Ophthalmology and Strabismus
|January 1, 1992
Summary
The Faden operation for dissociated vertical deviation (DVD) shows superior long-term results compared to large recessions. Combining the Faden operation with a 3mm recession is recommended for larger deviations.
Area of Science:
- Ophthalmology
- Strabismus Surgery
Background:
- Dissociated vertical deviation (DVD) is a common strabismus condition.
- Surgical management of DVD aims to improve binocularity and cosmetic appearance.
Purpose of the Study:
- To evaluate the immediate and long-term efficacy of three surgical procedures for treating dissociated vertical deviation (DVD).
- To compare the outcomes of the Faden operation versus large recessions of the superior rectus muscle.
Main Methods:
- Retrospective study of 42 patients undergoing surgery between 1982 and 1990.
- Three surgical techniques were analyzed: Faden operation (n=10), Faden operation with 3mm recession (n=7), and large recession (n=25).
- Comparison of immediate and long-term effects on dissociated vertical deviation (DVD).
Main Results:
- Initial effectiveness of the Faden operation and large recession for DVD was comparable.
- The Faden operation demonstrated significantly superior long-term outcomes compared to large recessions.
- A minimum 3mm recession combined with the Faden operation is advised for deviations exceeding 14 prism diopters to prevent undercorrection.
Conclusions:
- The Faden operation is an effective surgical treatment for dissociated vertical deviation (DVD) with excellent long-term results.
- Combined Faden operation and recession technique offers better outcomes for significant DVD angles.
- Results suggest the Faden operation is a preferred surgical choice for long-term DVD management.