Surgical treatment of combined vertical tropias: dissociated vertical deviation and primary hyperfunction of the inferior oblique ocular muscles

We have treated 27 children with DVD and primary overaction of the inferior oblique muscles in the same time. In all of them we have done recession of the inferior oblique muscles (for 4, 6, 8 or 10 mm). In only seven of them we did recession of the superior recti (for 7, 8 or 9 mm) simultaneously. DVD doesn't need to be operated in every child. Large recession of the superior rectus muscles very significantly and adequately ameliorate the DVD in 79% of children. Hypocorrection of the DVD we have in another 21% of the operated eyes. We get valid results one month after the surgery. They were constant after six months too.