Session: Free papers Session VI - Vertical Strabismus

Surgical treatment of larger DVD in the fixing eye

It is often assumed that asymmetric DVD is larger in the non-fixing eye. However, cases with larger DVD in the fixing eye do exist and require a specific surgical treatment

Methods: Retrospective study of patients who underwent surgery for asymmetric DVD with an asymmetry > or = of 5 PD between each eye. We recorded visual acuity, amount of DVD in each eye obtained with prism cover test, incomitance pattern, fixing eye , asymmetry of the vertical deviation and performed surgical treatment.

Results:18/32 patients that had surgery for DVD had larger DVD in the fixing eye. The mean age was 13,5 years ( range 10-21). 8/18 had A pattern, 4/18 had V pattern and 6/18 did not have incomitance pattern. The average amount of asymmetry was 9.7 PD ( range of 5-22 PD) Regarding the employed surgical procedure, most cases with A pattern received bilateral asymmetric Superior Rectus recession larger in the fixing eye and patients with V pattern , bilateral graded IOAT

Conclusions:Asymmetric DVD larger in the fixing eye is a frequent clinical finding even in the presence of good bilateral visual acuity. Patients with asymmetric DVD have larger DVD in the fixing eye in half of the cases , independently of the presence of an alphabetical pattern or not. We found a tendency toward larger DVD in the fixing eye in patients with A pattern.