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Unilateral modified Harada-lto procedure for excyclotorsion secondary to unilateral superior oblique palsy
1Strabismus and Paediatric Service, Moorfields Eye Hospital, City Road, London, ECIV2PD, UK.
Background:
The Fells modification of the Harada-lto procedure is usually performed bilaterally for the correction of excyclotorsion secondary to acquired bilateral superior oblique paresis. Excyclotorsion is not usually a major complaint in true unilateral superior oblique paresis. Occasional cases, however, may find this symptom bothersome and it may interfere with fusion. The purpose of the present study is to determine the effect of the unilateral modified Harada-lto procedure on the correction of symptomatic excyclotorsion in unilateral superior oblique paresis.
Method:
A retrospective case-note review of patients with unilateral superior oblique paresis undergoing unilateral modified Harada-lto procedures during the five-year period 1988-1993 was performed.
Results:
Six patients fulfilled the inclusion criteria. Superior oblique paresis was congenital in one case, secondary to trauma in two cases and idiopathic acquired in three cases. There were four males and two females aged from 25 to 63 years and all but one had previous surgery. The mean pre-operative excyclotorsion was approximately 10 degrees (range 8-14 degrees). Mean post-operative excyclotorsion was 3 degrees (range 2 degrees incyclotorsion -10 degrees excyclotorsion).
Conclusion:
The unilateral modified Harada-lto procedure is an effective surgical treatment of excyclotorsion resulting from superior oblique paresis and may improve sensory and motor fusion.
