RCT of surgery to correct asymmetrical DVD
Reviewed by Fiona Rowe

This study compared the efficacy of two procedures: (1) bilateral symmetrical anteriorisation of the inferior oblique (AIO) and (2) combined resection and AIO, in cases of asymmetrical dissociated vertical deviation (DVD). This was a prospective randomised controlled trial including 54 patients: 27 per group. For group 1, mean preoperative DVD was 11.00 ±6.06PD right eye and 10.56 ±5.92PD left eye with inferior oblique overaction (IOOA) of 1.93 ±1.0 right and 1.69 ±0.80 left. In group 2, preoperative DVD was 11.43 ±3.90PD right and 8.96 ±4.33PD left, with IOOA of 1.74 ±0.96 right and 1.52 ±0.64 left. These measurements were not significantly different between groups. Postoperative deviation for group 1 was 1.81 ±4.25PD right and 1.78 ±3.77PD left and, for group 2, 1.11 ±2.15PD for the operated eye. Mean follow-up for all cases was 9.18 ±3.46 months. Results were not significantly different between groups and reductions in asymmetry were similar. There were no cases postoperatively of antielevation syndrome and no narrowing of the palpebral fissures. DVD was controlled in both groups postoperatively. On the basis of these results, the authors recommend bilateral AIO only as the added resection failed to show a superior benefit.

Anteriorization of the inferior oblique muscle vs anteriorization and resection for asymmetric dissociated vertical deviation.
Osama H, Elhilali H, Salah M, Fouad HM.
STRABISMUS
2025;33(1):28–35.