An interventional study of resection of superior rectus muscle in Dissociated Vertical Deviation, sponsored by Assiut University. Not yet recruiting. Open to participants aged 1 Day to 6 Months. Per ClinicalTrials.gov, last updated 2026-10-20.
Sponsored by Assiut University · Not applicable, Interventional, and Health services research
Dissociated vertical deviation (DVD) is a slow, disconjugate upward drift of the non-fixating eye, usually with abduction and excyclotorsion, that does not obey Hering's law . It is uncommon in the general population but develops in about half to 90% of children with infantile esotropia . Its cause is uncertain, probably a supranuclear vertical vergence disturbance after early disruption of binocular fusion, which explains its association with infantile esotropia . Non-surgical treatment suits small or well-controlled deviations: refractive correction, amblyopia therapy . Surgery is indicated when the deviation is frequently manifest or cosmetically unacceptable . When inferior oblique overaction coexists, anterior transposition of the inferior oblique is the procedure of choice . In isolated DVD, surgery aims mainly to weaken the superior rectus (SR). Conventional graded SR recession is the most widely used , but large deviations may need 10 mm or more and undercorrection is common . Recession-resection resects part of the muscle then recesses it by a greater amount, raising the weakening effect , while fenestration removes a central block of muscle and tendon near the insertion without sutures and is simpler and faster . Other options are a posterior fixation (Faden) suture and Y-splitting . The evidence is weak: a Cochrane review found the published studies small and retrospective and asked for randomized trials , and the only comparison of three SR techniques allocated patients by deviation size rather than at random . No trial has compared fenestration with recession-resection in children with DVD.
Dissociated vertical deviation (DVD) is a slow, disconjugate upward drift of the non-fixating eye, usually with abduction and excyclotorsion, that does not obey Hering's law . It is uncommon in the general population but develops in about half to 90% of children with infantile esotropia . Its cause is uncertain, probably a supranuclear vertical vergence disturbance after early disruption of binocular fusion, which explains its association with infantile esotropia . Non-surgical treatment suits small or well-controlled deviations: refractive correction, amblyopia therapy . Surgery is indicated when the deviation is frequently manifest or cosmetically unacceptable . When inferior oblique overaction coexists, anterior transposition of the inferior oblique is the procedure of choice . In isolated DVD, surgery aims mainly to weaken the superior rectus (SR). Conventional graded SR recession is the most widely used, but large deviations may need 10 mm or more and undercorrection is common . Recession-resection resects part of the muscle then recesses it by a greater amount, raising the weakening effect , while fenestration removes a central block of muscle and tendon near the insertion without sutures and is simpler and faster . Other options are a posterior fixation (Faden) suture and Y-splitting . The evidence is weak: a Cochrane review found the published studies small and retrospective and asked for randomized trials , and the only comparison of three SR techniques allocated patients by deviation size rather than at random . No trial has compared fenestration with recession-resection in children with DVD.
159 studies on the registry are indexed under Strabismus; 31 are open to participants now.
This study's planned enrollment of 30 is below the median of 60 across 98 interventional studies indexed under Strabismus.
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Of its 14 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Clinically manifest DVD of at least 15 prism diopters (PD) in the more affected eye, by prism and alternate cover test.
Exclusion Criteria:
Significant inferior oblique overaction or oblique dysfunction requiring simultaneous oblique muscle surgery.
graded recession of the superior rectus muscle alone, the amount graded to the preoperative DVD by the Tibrewal nomogram
Other: resection of superior rectus muscle
a 2.5 mm segment of the SR resected, followed by recession of the muscle exceeding the resected length, graded to the preoperative DVD by the Tibrewal nomogram
Other: resection of superior rectus muscle
a central block of the SR muscle and its tendon removed close to the insertion, without disinsertion or scleral sutures, graded to the preoperative DVD
Other: resection of superior rectus muscle
resection of superior oplique muscle
Compare success rates in the 3 groups.
Compare success rates in the 3 groups. Success is defined as absence of manifest DVD at final follow up
Time frame: 6 months
recurrence at 6 months and reoperation rate.
recurrence at 6 months and reoperation rate.
Time frame: 6 months
Torsional outcome
fundus torsion (disc-fovea angle) before and after surgery.
Time frame: 6 months
No study locations are listed for this record.
Plan to share: Undecided
No publications or documents are linked to this record.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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