الفهرس 
Title : Comparison Between Anteriorization of the Inferior Oblique Muscle versus Anteriorization and Resection as the Surgical Management of Asymmetrical Dissociated Vertical Deviation: A Prospective Comparative Study
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Abstract
Objectives
To compare the efficacy of bilateral symmetric anteriorization of the inferior oblique muscle versus combined resection and anteriorization of the inferior oblique for bilateral asymmetric dissociated vertical deviation (DVD) with inferior oblique overaction.
Methods
The study is a randomized, comparative clinical study. It includes fifty-four patients presenting with bilateral manifest asymmetric DVD and inferior oblique overaction (IOOA). Twenty-seven patients underwent bilateral symmetric anteriorization of the IO muscle (group I) and twenty-seven patients underwent anteriorization of the IO in one eye and anteriorization with IO resection in the eye with the larger deviation (group II). According to the difference in measured DVD between the two eyes whether less, or more than 5 PD; a 3 or 5 mm resection was done, respectively.
Results
In group I, the mean preoperative DVD was reduced from 11.00±6.06 PD and 10.56±5.92 PD to 1.81±4.25 PD and 1.78±3.77 PD after surgery in the right and left eye respectively with a mean reduction of 9.19±3.40 PD and 8.78±4.17 PD (P-value 0.0002). In group II, the mean pre-operative DVD was reduced from 11.48±3.90 PD and 8.96± 4.33 PD to 0.67±1.64 PD and 0.11±2.38 PD in the right and left eye respectively with a mean reduction of 10.81±3.79 and 9.07±4.15 PD (P-value 0.0003)in the left eye. IOOA was significantly reduced in both groups. There was no statistically significant difference in improvement in the mean post-operative DVD and IOOA between the two groups (P-value 0.265) and (P-value 0.804) respectively.
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Conclusions
Bilateral IO anteriorization and anteriorization with a 3-5 mm resection of the inferior oblique muscle in eyes with larger deviation are both effective modalities of surgical management of asymmetric disscociated vertical deviation associated with IOOA.