Unilateral tucking of the inferior rectus muscle as treatment for dissociated vertical deviation

Background: There are several options for the treatment of dissociated vertical deviation (DVD). The most discouraging results are those cases of poor vision. The tuck of the inferior rectus is presented as a therapeutic option for poor vision. Methods: Patients with spontaneous DVD and monocular poor vision were included. A maximum tucking of the inferior rectus was performed only in the eye with poor vision. Evaluation of the spontaneity and magnitude of the DVD was done pre- and postoperatively with a minimum 6-month follow-up. Results: Nineteen patients were included, finding a decrease in the spontaneity (p = 0.05) and the magnitude of the DVD (p = 0.01) at the maximum follow-up time. Limitation of the elevation of 2+ was observed in the immediate postoperative period in all cases. The limitation remained in 16 patients. In two patients, hypotropia of 5 DP was observed in the primary position. No cases of alteration of the lower palpebral position were observed. Conclusions: Unilateral maximum tucking of the inferior rectus muscle decreases the magnitude and spontaneity of DVD.