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November 1980

Dissociated Vertical Deviation-Reply

Author Affiliations

New York

Arch Ophthalmol. 1980;98(11):2083. doi:10.1001/archopht.1980.01020040935033

In Reply.  —Dr Porter is correct that the posterior fixation suture procedure was originally described by Cüppers1 with reattachment of the muscle to its anatomic insertion. However, we did not take up this operation until Muhlendyck, an associate of Cüppers, reported at the International Orthoptic Congress in Boston in July 1975. Muhlendyck2 said that it was necessary to recess the muscle also. Jampolsky' and others have reported on recession of the superior rectus muscle to correct DVD. At last report, they were recessing the superior rectus muscle 12 mm to stop the updrift of DVD, so a 5-mm recession plus a faden operation seems a good trade. In patients with a hypotropia in primary position in which, at times, the hypotropic eye drifts greatly up, a minimal recession of 1.5 to 2 mm was done with the faden operation. Otherwise, as stated, a recession is also required. The

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