ABSTRACT
ABSTRACT: Purpose: To investigate the development of Dissociated Vertical Deviation (DVD) in infantile esotropia and its relationship with the age and the technique of the surgical intervention. Material and Method: Retrospectively records of 144 infantile esotropia cases that were followed in our clinic between the dates January 1991 – December 1997 were examined. Their ages at the time of admission, risk factors, ophthalmologic examinations before and after treatment and treatment mode were recorded and compared. Results: DVD was found to develop in approximately half of the cases (47.9%) at an average age of 3.2 years (20 months-5.5 years) regardless of the treatment. DVD developed in 80.5% of cases that had no surgery and 37.5% of the cases that were treated surgically. When we compared according to the age, it was seen that 24.1% of the cases that were treated between ages 6 months and 2 years and 52% of the cases that were treated after 2 years of age had DVD and the difference was significant (p 0.01). In comparison to the surgical technique, DVD developed in 34.8% of the cases that had bimedial rectus recession and in 38% of the cases with unilateral recession and resection of rectus muscles without any significance (p 0.05). Conclusion: As a result, the most efficient treatment mode in infantile esotropia is surgical intervention in early periods to obtain less DVD development as well as other established goals such as to obtain binocularity and prevent amblyopia. It is concluded that DVD development increases if surgery is not performed, if it is performed at later ages, and if additional muscle surgery is needed in time for undercorrection.
