Purpose: To clarify the incidence of dissociated vertical deviation (DVD) among patients with congenital esotropia and to identify any relationship between the time when patients undergo their initial strabismus surgery and the time when they may subsequently have DVD develop. Design: Noncomparative case series. Participants: One hundred five consecutive patients undergoing surgery for congenital esotropia over a 10-year period. Methods: All patients underwent bimedial rectus recession before 24 months of age. Main Outcome Measures: Patients were followed postoperatively to note the age at onset of clinically evident DVD. Results: By 6 years of age, 92% of available patients had DVD. The mean age at onset was 2.81 ± 1.37 years. There was no significant difference between patients surgically aligned before 6 months of age compared with those aligned between 6 and 12 or 12 and 24 months of age. Conclusions: DVD occurs in almost all patients with surgically treated congenital esotropia, and its development is unrelated to the timing of surgical intervention during the first 24 months of life.
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