Superior rectus recessions for dissociated vertical deviation.

Thirty-two eyes of 31 patients received superior rectus recessions for the treatment of dissociated vertical deviation (DVD). All patients were followed for a postoperative period of at least six months, and 50% were followed for a period of three years or more. The differential diagnosis of DVD and inferior oblique overaction was important, and the distinguishing features of each are mentioned. A distinction was made between occlusion hyperphoria, a latent deviation in the preferred fixating eye, and DVD, a manifest deviation in the nonpreferred eye. In the vast majority of cases, a unilateral superior rectus recession of graduated amounts was performed in the eye with a cosmetically unacceptable DVD. The surgical "hang loose" technique permitted avoiding technically difficult situations. After operation 82% of the eyes were aligned, within the good to excellent categories (0-9 prism diopters).