ABSTRACT
ABSTRACT: Twenty one patients, presenting a residual manifest DVD, after one to three procedures to control it, were retrospectively studied. They were treated by anterior transposition of the inferior oblique muscle (ATPIO) at zero, 1 or 2, in association with a resection of the proximal part of the IO tendon in three cases and with a re-recession of the superior rectus (SR) in three other cases. The mean age at surgery was 8.4 years (1.5-42). No patient had any ATIO before and they were all operated by the same surgeon (VP). Preoperatively, a residual vertical lateral incomitance was present in 24% of the cases and a V pattern in 19%. A latent DVD was finally obtained in all cases but two. One of these two cases was reoperated 3 years later in the same manner on the other eye and led to a stable good result. The mean follow up is 4 years (0.6-7). No significant side effect was observed. However, a residual upgaze limitation was small in three cases and mild in one case without provoking any chinup head posturing.
