Clinical Features and Refractive Profile of Surgical Patients With Dissociated Vertical Deviation Publisher Pubmed



Akbari MR ; Khorraminejad M ; Mohammed AA ; Narooienoori F ; Yousefi R ; Javadi S
Source: European Journal of Ophthalmology Published:2026

Abstract

Background: To report the deviation type, visual and refractive characteristics of patients with dissociated vertical deviation (DVD) requiring unilateral or bilateral strabismus surgery. Methods: This study included 180 patients with DVD who underwent unilateral or bilateral strabismus surgery at Farabi Eye Hospital.Age, refractive error (RE), Corrected distance visual acuity (CDVA), strabismus angle, presence of amblyopia, and postoperative outcome. Results: Thirty-eight patients were in unilateral (78.9% bilateral) group. In the unilateral group, CDVA was significantly worse in surgical eyes versus fellow eyes (P < .001). The mean spherical equivalent in surgical eyes was insignificantly hyperopic than fellow eyes (P = 0.354). The mean angle of DVD was greater at distance than near (P < .05). Furthermore, the most prevalent type was “DVD plus horizontal deviation” (47.4%), followed by pure DVD (23.7%), “combined DVD, hypertropia (HT) and horizontal deviation” (13.2%), and “HT plus DVD” (15.8%). CDVA in cases needing bilateral surgery in the right and left eye were 0.91 ± 0.17 and 0.90 ± 110.17, respectively.In the bilateral group, RE components were similar between eyes but lower than surgical eyes in patients with unilateral surgery (P < .05). Moreover, the mean angle of DVD was higher at a distance compared to near.The most prevalent type was “DVD plus horizontal deviation” (64.1%), followed by pure DVD (18.3%), “combined DVD, HT and horizontal deviation” (13.4%), and “HT plus DVD” (4.2%). Conclusions: The study highlighted significant differences in VA, RE, and prevalence of amblyopia between the two groups.Furthermore, the varying types of coexisting deviations observed in unilateral and bilateral surgery cases emphasize the importance of personalized treatment approaches for patients with DVD. © The Author(s) 2025