Mean Total Deviation Research Articles

The Relationship Between Visual Acuity and the Reproducibility of Visual Field Measurements in Glaucoma Patients.

The purpose of this study was to investigate the association between visual acuity (VA) and reproducibility of test-retest visual field (VF) measurements in glaucoma patients. Subjects were comprised of 627 eyes of 627 open-angle glaucoma patients. The reproducibility of two Humphrey VFs (24-2 or 30-2 Swedish Interactive Threshold Algorithm tests) examined twice within the period of 3 months was calculated using the root mean squared error (RMSE) of each VF test point's sensitivity. Visual acuity was measured once at the time of either of the VF measurements. Linear modeling was used to investigate the relationship between reproducibility of VF tests (RMSE) and the following variables: mean total deviation value (mTD), fixation losses (FLs), false positives (FPs), false negatives (FNs), refractive error, age, and VA. The optimal model to predict test-retest variability (RMSE) of VFs included age, VA, mTD, and FNs as dependent variables. Root mean squared error was significantly larger in eyes with logMAR VA > 0.5 than in eyes with logMAR VA ≤ 0. Reproducibility of VF tests becomes poor with the deterioration of VA. Careful consideration is needed when a patient's logMAR VA exceeds 0.5.

Analysis of Different Fragmentation Strategies on a Variety of Large Peptides: Implementation of a Low Level of Theory in Fragment-Based Methods Can Be a Crucial Factor.

We have investigated the performance of two classes of fragmentation methods developed in our group (Molecules-in-Molecules (MIM) and Many-Overlapping-Body (MOB) expansion), to reproduce the unfragmented MP2 energies on a test set composed of 10 small to large biomolecules. They have also been assessed to recover the relative energies of different motifs of the acetyl(ala)18NH2 system. Performance of different bond-cutting environments and the use of Hartree-Fock and different density functionals (as a low level of theory) in conjunction with the fragmentation strategies have been analyzed. Our investigation shows that while a low level of theory (for recovering long-range interactions) may not be necessary for small peptides, it provides a very effective strategy to accurately reproduce the total and relative energies of larger peptides such as the different motifs of the acetyl(ala)18NH2 system. Employing M06-2X as the low level of theory, the calculated mean total energy deviation (maximum deviation) in the total MP2 energies for the 10 molecules in the test set at MIM(d=3.5Å), MIM(η=9), and MOB(d=5Å) are 1.16 (2.31), 0.72 (1.87), and 0.43 (2.02) kcal/mol, respectively. The excellent performance suggests that such fragment-based methods should be of general use for the computation of accurate energies of large biomolecular systems.

Do pattern deviation values accurately estimate glaucomatous visual field damage in eyes with glaucoma and cataract?

To study the efficacy of pattern deviation (PD) values in the estimation of visual field compensating the influence of cataract in eyes with glaucoma. The study subjects comprised of 48 eyes of 37 glaucoma patients. Mean total deviation value (mTDs) on Humphrey Field Analyzer after cataract surgery was compared with mean PD (mPD) before the surgery. Visual field measurements were carried out ≤6 months before (VF(pre)) and following (VF(post)) successful cataract surgery. The difference between the mPD or mTD values in the VF(pre) and mTD values in the VF(post) (denoted as εmPD/ΔmTD) was calculated, and the influence of the extent of 'true' glaucomatous visual field damage or cataract (as represented by εmPD and ΔmTD, respectively) on this difference was also investigated. There was a significant difference between mTD in the VF(pre) and mTD in the VF(post) (p<0.001, repeated measures analysis of variance). There was not a significant difference between mPD in the VF(pre) and mTD in the VF(post) (p=0.06); however, εmPD was significantly correlated with the mTD in VF(post) and also ΔmTD (R(2)=0.56 and 0.27, p<0.001, Pearson's correlation). The accurate prediction of the mTD in the VF(post) can be achieved using the pattern standard deviation (PSD), mTD and also visual acuity before surgery. Clinicians should be very careful when reviewing the VF of a patient with glaucoma and cataract since PD values may underestimate glaucomatous VF damage in patients with advanced disease and also overestimate glaucomatous VF damage in patients with early to moderate cataract.

Areas of the visual field important during reading in patients with glaucoma.

To determine the areas of the binocular visual field (VF) associated with reading speed in glaucomatous patients with preserved visual acuity (VA). Fifty-four patients with glaucoma (mean age ± standard deviation 70 ± 8 years) and 38 visually healthy controls (mean age 66 ± 9 years) had silent reading speeds measured using non-scrolling text on a computer setup. Participants completed three cognitive tests and tests of visual function, including the Humphrey 24-2 threshold VF test in each eye; the results were combined to produce binocular integrated VFs (IVFs). Regression analyses using the control group to correct for cognitive test scores, age and VA were conducted to obtain the IVF mean deviation (MD) and total deviation (TD) value from each IVF test location. Concordance between reading speed and TD, assessed using R (2) statistics, was ranked in order of importance to explore the parts of the IVF most likely to be linked with reading speed. No significant association between IVF MD value and reading speed was observed (p = 0.38). Ranking individual thresholds indicated that the inferior left section of the IVF was most likely to be associated with reading speed. Certain regions of the binocular VF impairment may be associated with reading performance even in patients with preserved VA. The inferior left region of patient IVFs may be important for changing lines during reading.

A new approach to measure visual field progression in glaucoma patients using variational bayes linear regression.

We generated a variational Bayes model to predict visual field (VF) progression in glaucoma patients. This retrospective study included VF series from 911 eyes of 547 glaucoma patients as test data, and VF series from 5049 eyes of 2858 glaucoma patients as training data. Using training data, variational Bayes linear regression (VBLR) was created to predict VF progression. The performance of VBLR was compared against ordinary least-squares linear regression (OLSLR) by predicting VFs in the test dataset. The total deviation (TD) values of test patients' 11th VFs were predicted using TD values from their second to 10th VFs (VF2-10), the root mean squared error (RMSE) associated with each approach then was calculated. Similarly, mean TD (mTD) of test patients' 11th VFs was predicted using VBLR and OLSLR, and the absolute prediction errors compared. The RMSE resulting from VBLR averaged 3.9 ± 2.1 (SD) and 4.9 ± 2.6 dB for prediction based on the second to 10th VFs (VF2-10) and the second to fourth VFs (VF2-4), respectively. The RMSE resulting from OLSLR was 4.1 ± 2.0 (VF2-10) and 19.9 ± 12.0 (VF2-4) dB. The absolute prediction error (SD) for mTD using VBLR was 1.2 ± 1.3 (VF2-10) and 1.9 ± 2.0 (VF2-4) dB, while the prediction error resulting from OLSLR was 1.2 ± 1.3 (VF2-10) and 6.2 ± 6.6 (VF2-4) dB. The VBLR more accurately predicts future VF progression in glaucoma patients compared to conventional OLSLR, especially in short VF series.

Modified Moment, Maximum Likelihood and Percentile Estimators for the Parameters of the Power Function Distribution

This paper is concerned with the modifications of maximum likelihood, moments and percentile estimators of the two parameter Power function distribution. Sampling behavior of the estimators is indicated by Monte Carlo simulation. For some combinations of parameter values, some of the modified estimators appear better than the traditional maximum likelihood, moments and percentile estimators with respect to bias, mean square error and total deviation.

Effect of Ginkgo biloba Extract on Visual Field Progression in Normal Tension Glaucoma

To evaluate the long-term effect of Ginkgo biloba extract (GBE) on progression of visual field (VF) defects in patients with normal tension glaucoma (NTG). Forty-two eyes of 42 patients with treated NTG who received 80 mg GBE 2 times daily and who had at least 5 VF tests using the Humphrey Visual Field Analyzer for more than a 4-year period before and after GBE treatment were evaluated in this retrospective study. We evaluated the change of progression rate using mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI) after GBE treatment. The time course of mean total deviation in 10 zones corresponding to the glaucoma hemifield test was analyzed using a linear mixed effects model with unequal random effect variances. The mean follow-up period was 12.3 years. The posttherapeutic intraocular pressures before and after GBE treatment were not significantly different (P=0.509 paired t test). Before GBE treatment, the regression coefficients (RCs) of MD, PSD, and VFI change were -0.619 dB/y, 0.626 dB/y, and -2.153%/y, respectively. After GBE treatment, the RCs of MD, PSD, and VFI change improved significantly to -0.379 dB/y, 0.342 dB/y, and -1.212%/y (P <0.001), respectively. In zone 1, the RC of mean total deviation change was significantly increased after GBE administration (P <0.005). GBE administration slowed the progression of VF damage in patients with NTG, especially in zone 1 corresponding to the superior central field.

Development of a new strategy of visual field testing for macular dysfunction in patients with open angle glaucoma

To explore methods of automated visual field (VF) examination for the assessment of macular function. We used a VF examination (AP-7000 automatic perimeter, Kowa, Japan) to examine macular function in 53 eyes from 29 patients with open angle glaucoma. We measured the mean total deviation (c-MD) of 16 points in the central VF located in a 2-degree-interval 4 × 4 array with various stimulus sizes (Goldmann sizes III, II, and I). The retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC), and ganglion cell layer plus inner plexiform layer (GCL + IPL) were measured with the 3D OCT-2000 System (Topcon, Japan). The c-MDs of various stimulus sizes were compared with the OCT parameters using the Spearman rank correlation. The average examination time was 93.5 ± 23.5 s and the c-MD values were -11.8 ± 8.2 (stimulus size III), -11.9 ± 9.5 (stimulus size II), and -12.3 ± 9.6 dB (stimulus size I). The c-MD (stimulus size III) and averaged total deviations of the Humphrey Field Analysis 10-2 program were significantly correlated (ρ = 0.91). The C-MD values for stimulus size III were significantly correlated with the OCT parameters (RNFL: ρ = 0.59; GCC: ρ = 0.65; and GCL + IPL: ρ = 0.64). The correlation coefficient between the c-MD and the GCC was better for stimulus sizes II and I (ρ = 0.69) than for stimulus size III (ρ = 0.65). The C-MD values for the 16 measured central VF points were significantly correlated with macular structure, and the smaller stimulus sizes of the automated VF test had a higher correlation coefficient of within 8°.

Assessment of macular function of glaucomatous eyes by multifocal electroretinograms

To determine whether significant correlations existed between the morphological and functional parameters of the macular region of eyes with open-angle glaucoma (OAG). Forty eyes of 40 OAG patients were studied. The morphological parameters were obtained by optical coherence tomography (OCT), and the functional parameters were acquired by automated Humphrey Field Analyzer (HFA) and multifocal electroretinograms (mfERGs). All of the tests were performed within 6months of each other. The retinal thickness was determined by OCT in the nine Early Treatment of Diabetic Retinopathy Study (ETDRS) sectors of the macula, the fovea, and the four quadrants of the inner and an outer ring. The amplitudes of the second-order kernel responses of the mfERGs in the central 5° including the amplitude ratio of the nasal to temporal hemispheres (N/T amplitude ratio) were analyzed. The total mean deviation of the HFA corresponding to each OCT region was measured. The correlation between the different parameters was determined by coefficients of correlation and linear regression analyses. The N/T amplitude ratio of the second-order kernel responses of the mfERGs was significantly correlated with the retinal thickness in the inferior quadrant (r=-0.44; P=0.004). There was a significant correlation between the N/T amplitude ratio and the threshold in the superior quadrant measured by the HFA Central 10-2 program (r=-0.40; P=0.011) and also between the N/T amplitude ratio and the total deviation in the superior quadrant (r=-0.40; P=0.010). There were significant correlations between the inferior retinal thickness and the average threshold and the TD in superior (r=0.70, P<0.001; r=0.692, P<0.001, respectively), nasal (r=0.53, P<0.001; r=0.53, P<0.001, respectively), and temporal (r=0.46, P=0.003; r=0.44, P=0.004, respectively) quadrants. Functional glaucomatous changes determined by mfERGs and perimetry are significantly correlated with the morphological changes determined by OCT.

Central 10-degree visual field change following trabeculectomy in advanced open-angle glaucoma

To prospectively examine changes in the central visual field (VF) in patients with advanced open-angle glaucoma (OAG) with advanced late stage after trabeculectomy for 12 months. Prospective interventional case series. In all, 27 eyes of 27 OAG patients at a single center with a best-corrected visual acuity (BCVA) of ≥40/200 and a mean total deviation of test locations of the 10-2 program of the Humphrey VF analyzer of ≤-20 dB preoperatively were enrolled. Intraocular pressure (IOP), VF parameters of the 10-2 program, and BCVA were examined for 12 months after trabeculectomy with mitomycin C. Slopes of VF parameters and their correlation with presumed risk factors were studied. IOP decreased from 19.7±5.8 to 9.7±2.6 mm Hg (P<0.001) over postoperative 1 year. The slopes of all VF parameters did not significantly differ from zero (P>0.33), and none of the presumed factors significantly correlated with the slopes of those parameters (P>0.14). There were two eyes (7%) and one eye (4%) with ≥2 lines of deterioration in BCVA (decimal fraction) at 1 and 12 months, respectively, after surgery with no apparent causes. Trabeculectomy resulted in little change in the central 10-degree VF, but significant decrease in BCVA without apparent causes might occur approximately 5% of the cases.

Experimental study on saturated flow boiling heat transfer of R290/R152a binary mixtures in a horizontal tube

An experimental study on the saturated flow boiling heat transfer for a binary mixture of R290/R152a at various compositions is conducted at pressures ranging from 0.2 to 0.4 MPa. The heat transfer coefficients are experimentally measured over mass fluxes ranging from 74.1 to 146.5 kg/(m2·s) and heat fluxes ranging from 13.1 to 65.5 kW/m2. The influences of different parameters such as quality, saturation pressure, heat flux, and mass flux on the local heat transfer coefficient are discussed. Existing correlations are analyzed. The Gungor-Winterton correlation shows the best fit among experimental data for the two pure refrigerants. A modified correlation for the binary mixture is proposed based on the authors’ previous work on pool boiling heat transfer and the database obtained from this study. The result shows that the total mean deviation is 10.41% for R290/R152a mixtures, with 97.6% of the predictions falling within ±30%.

Progression rate of total, and upper and lower visual field defects in open-angle glaucoma patients

PurposeWe evaluated the progression rate of total, and upper and lower visual field defects in treated open-angle glaucoma patients.Patients and methodsThis study was a retrospective, nonrandomized, comparative study. Five-hundred forty-four eyes from 315 Japanese open-angle glaucoma patients were examined. The mean deviation (MD) and total deviation (TD) for both the upper and lower slopes on the Humphrey Field Analyzer were calculated and compared in high-tension glaucoma (>21 mmHg) and normal-tension glaucoma (≤21 mmHg).ResultsPatients with over −20 dB of MD and over −23 dB of upper or lower TD were enrolled into each analysis. Patients with −7.75 ± 5.30 (mean ± standard deviation) dB of MD, −9.16 ± 10.80 dB of upper TD, or −7.11 ± 6.02 dB of lower TD were followed up for 4–19 years. The mean MD slope was −0.41 ± 0.50 dB/year, the upper TD slope was −0.46 ± 0.65 dB/year, and the lower TD slope was −0.32 ± 0.53 dB/year. Comparing high-tension glaucoma and normal-tension glaucoma, the upper TD slope was similar for both types of glaucoma, but the MD and lower TD slopes in high-tension glaucoma were significantly lower than those in normal-tension glaucoma.ConclusionsThe progression rates in lower visual field defects in high-tension glaucoma might be faster than those in normal-tension glaucoma. The results of this study might be used to predict the prognosis of visual field defects, as well as the quality of vision in patients with open-angle glaucoma.

Experimental study on saturated flow boiling heat transfer of R170/R290 mixtures in a horizontal tube

Saturated flow boiling heat transfer coefficients in a horizontal tube of the binary mixtures of R170/R290 were measured. The experiments were performed at three different mixture compositions and various saturation pressures from 0.35 to 0.57 MPa. The results were obtained over the mass fluxes ranging from 63.6 to 102.5 kg m −2 s −1 and heat fluxes ranging from 13.1 to 65.5 kW m −2. The influences of quality, saturation pressure, heat flux and mass flux on the heat transfer characteristic were examined and discussed. The flow pattern of mixture was shown and the transitions of flow pattern occur at higher mass flux and quality for mixtures than for pure substance. A modified correlation was developed based on the previous research of our group on the pool boiling heat transfer and the database obtained from this study. The comparison of the experimental heat transfer coefficient with the predicted value using the present correlation shows that the total mean deviation is 15.97% for R170/R290 mixtures.

Genetic algorithms for job shop scheduling problems with alternative routings

The purpose of this research is to solve a general job shop problem with alternative machine routings. We consider four performance measures: mean flow time, makespan, maximum lateness, and total absolute deviation from the due dates. We first develop mixed-integer linear programming (MILP) formulations for the problems. The MILP formulations can be used either to compute optimal solutions for small-sized problems or to test the performance of existing heuristic algorithms. In addition, we have developed a genetic algorithm that can be used to generate relatively good solutions quickly. Further, computational experiments have been performed to compare the solution of the MILP formulations with that of existing algorithms.

Extended Radical Lymphadenectomy in Patients With Urothelial Bladder Cancer:: Results of a Prospective Multicenter Study

Previous studies demonstrate a positive correlation between postoperative survival and the extent of pelvic lymphadenectomies in patients with bladder cancer. However, the distribution of nodal metastases has not been examined in sufficient detail. Therefore, we conducted a comprehensive prospective analysis of lymph node metastases to obtain precise knowledge about the pattern of lymphatic tumor spread. Between 1999 and 2002 we performed 290 radical cystectomies and extended lymphadenectomies. Cranial border of the lymphadenectomy was the level of the inferior mesenteric artery, lateral border was the genitofemoral nerve and caudal border was the pelvic floor. We made every effort to excise and examine microscopically all lymph nodes from 12 well-defined anatomical locations. Mean total number and standard deviation of lymph nodes removed was 43.1 +/- 16.1. Nodal metastases were present in 27.9% of patients. The percentage of metastases at different sites ranged from 14.1% (right obturator nodes) to 2.9% (right paracaval nodes above the aortic bifurcation). By studying cases of unilateral primary tumors or with only 1 metastasis we observed a preferred pattern of metastatic spread. However, there were many exceptions to the rule and we did not identify a well-defined sentinel lymph node. We strongly recommend extended radical lymphadenectomy to all patients undergoing radical cystectomy for bladder cancer to remove all metastatic tumor deposits completely. The operation can be conducted in routine clinical practice and our data may serve as a guideline for future standardization and quality control of the procedure.

Extension of the density functional derived scaled quantum mechanical force field procedure

The density functional derived scaled quantum mechanical (SQM) force field method of Rauhut and Pulay [J. Phys. Chem. 99 (1995) 3093] has been extended. The original procedure (employing B3-LYP/6-31G* computations and 11 transferable scale factors for the different kinds of internal coordinates) was capable to reproduce the vibrational fundamentals of 31 simple organic (H, C, N, O) molecules with a total mean deviation of about 13 cm −1. The present Density Functional Theory based SQM force field method is an extension of the original one: with the help of 20 transferable scale factors can reproduce the fundamentals of 20 inorganic, organic and organosilicon molecules containing nonmetallic first and second-row atoms with a total mean deviation of 10.8 cm −1. The transferability and reliability of the new set of scale factors are demonstrated on the examples of the a priori SQM vibrational spectra of cis and gauche-cyclopropylchlorosilane.

Assessment of the plastic flows in The Netherlands using STREAMS

Abstract The STREAMS method, a method for material flow analysis based on national supply and use tables, is examined in an assessment of the flows of plastics in The Netherlands, for the reference year 1990. The method proves to be a powerful tool to get a total overview of plastic flows in The Netherlands. Using the method, it is possible to obtain a highly detailed view on the final consumption of materials, for which hitherto only highly aggregated estimates were available. With the STREAMS method, total final plastics consumption in The Netherlands in the year 1990 is calculated at 1260 kt, which fairly matches other estimates in literature. The STREAMS method also provides information on the final consumption of plastics on lower aggregation levels, e.g. the final consumption of plastics divided between industry sectors, split up between packaging, components and final products. Our calculations show that with regard to plastics in The Netherlands, apparent consumption, calculated as raw materials production plus imports minus exports, although easily calculable, is a rather poor approximation for final consumption. Several issues that affect the accuracy of the results of the STREAMS method are discussed and estimates are made of their contributions to the mean deviation of the results. Total mean deviation is calculated at ±30% for results presented on lower aggregation levels. On higher aggregation levels the accuracy of the results is much higher.

Foveal Dysfunction and Central Visual Field Loss in Glaucoma

To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma. University affiliated hospital and private practice. Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers. Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD). Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P<.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD. Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.

Visual Field Defects in Normal-tension and High-tension Glaucoma

Differences in visual field characteristics between normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) have not been established. This study re-examined the problem by pointwise between-group comparison of data obtained with the Humphrey 30-2 program. Sixty-eight NTG cases with maximum intraocular pressure (IOP) of 21 mmHg or lower and 62 HTG cases with maximum IOP of 25 mmHg or greater with a mean deviation (STATPAC) greater than -10 decibels (dB) were included. Age, refraction, mean deviation, or sex ratio were matched between the two groups. Total deviation (STATPAC), the difference between the measured threshold and the age-corrected normal reference at each test point of the 30-2 program, was used for pointwise between-group comparisons. Another parameter, total deviation - mean total deviation, was introduced to normalize the total deviation by the overall visual field damage as an index of disease stage. Mean total deviation is the average of total deviations across the test field. Further, logistic discriminant analysis was applied to confirm that the difference at a questioned test point was due to the difference of disease type, but not disease stage, between the two groups. Comparison using total deviation and total deviation - mean total deviation gave similar results, which were collaborated by logistic discriminant analysis. For a given amount of visual field damage, an area just above the horizontal meridian was significantly more depressed in NTG, while HTG had significantly more diffuse visual field damage. Visual field defect of NTG differs from that of HTG, which may suggest that different regions of the optic disc are more susceptible to damage in NTG.

Anterior Transposition of the Inferior Oblique Muscle for Dissociated Vertical Deviation

Recently, anterior transposition of the inferior oblique muscle was reported to be an effective treatment for dissociated vertical deviation (DVD), but data on long-term stability have not been reported. A retrospective, longitudinal analysis of 17 consecutive patients (22 eyes) with dissociated vertical deviation and inferior oblique overaction who had an anterior transposition of the inferior oblique for significant dissociated vertical deviation and a minimum of 12 months postoperative follow-up was undertaken. The size and degree of control of the dissociated vertical deviation and the degree of inferior oblique overaction were assessed preoperatively, and postoperatively at 1 week, at 4 to 6 months, and when last seen. The frequency of postoperative hypotropia and elevation deficits were noted. The mean preoperative dissociated vertical deviation measured 13.4 delta, and the mean total vertical deviation measured 16.2 delta in primary position at 6 meters. The mean dissociated vertical deviation at last follow-up measured 6.7 delta, and the mean total vertical deviation was 7 delta. The dissociated vertical deviation remained controlled based on objective evaluation and subjective patient/relative response in 19 of 22 eyes after a mean follow-up of 2 years (range, 1 to 4.9 years). It recurred in one eye by 6 months postoperatively and in 3 eyes at the last examination. The inferior oblique overaction did not recur to a significant extent in any patient. The best results were achieved in eyes with preoperative dissociated vertical deviations less than 15 delta (0 of 11 failures). When the preoperative dissociated vertical deviation measured > 15 delta, 3 of 11 were failures. Postoperative primary position hypotropia was uncommon (1 of 17 patients), whereas 27% of eyes had mild postoperative elevation deficits in abduction and adduction. Anterior transposition of the inferior oblique is an effective treatment for dissociated vertical deviation with inferior oblique overaction but may be less stable in the long term when the preoperative dissociated vertical deviation is in excess of 15 delta.