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The long-term torsion effect of the adjustable Harada-Ito procedure
Julie K Nishimura1, Arthur L Rosenbaum
1Jules Stein Eye Institute, University of California, Los Angeles, California 90095, USA.
Purpose:
The Harada-Ito procedure is a widely used technique in the treatment of excyclotorsion. While previous studies have demonstrated its initial success, long-term data have not been readily available. The purpose of this study is to describe the long-term torsion effect of the adjustable Harada-Ito procedure.
Methods:
All Harada-Ito procedures performed by 1 surgeon from 1982 to 1998 with at least 1 year of follow-up were reviewed. Torsion was evaluated using the double Maddox rods preoperatively, 1 day postoperatively, 2 months, 6 months, 1 year, 18 months, then annually thereafter. The effectiveness of the procedure was evaluated by comparing preoperative values to those at follow-up exams. The stability of the procedure was also evaluated by comparing torsion at 1 day and 2 months postoperatively to the torsion at subsequent exams. All comparisons were performed using the Student's t test.
Results:
Eighty Harada-Ito procedures were performed by 1 surgeon during this period. Nineteen patients had at least 1 year of follow-up (range, 1-7 years; mean, 2.0 years). Mean excyclotorsion values were 10.7 degrees preoperatively, 1.0 degrees at 1 day, 1.0 degrees at 2 months, 3.4 degrees at 6 months, 4.8 degrees at 1 year, and 5.3 degrees at 18 months. There was a significant improvement of excyclotorsion compared to preoperative torsion up to 12 months after surgery (P
Conclusions:
The Harada-Ito procedure is an effective procedure to treat excyclotorsion. However, regression toward excyclotorsion occurs between 2 months to 12 months postoperatively. These results suggest that an initial overcorrection may aid in long-term success of this procedure.