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- W1971569464 abstract "Patients with bilateral superior oblique palsies may complain of diplopia and torsion, especially in downgaze. They are difficult to manage surgically, although bilateral modified Harada-Ito procedures may be of value.A retrospective review was carried out of patients treated with bilateral Fells' modified Harada-Ito procedures for bilateral superior oblique palsy between 1989 and March 2000, the patients being identified from operating records.Twenty-three patients were identified (9 females and 14 males) with a mean age at presentation of 37 years (range 19 to 75). In 20 cases (87%) the aetiology was trauma (14 due to traffic accidents). All patients had diplopia at presentation (3 specifically mentioned torsion) with a mean duration of 22.5 months. Eleven patients had abnormal head postures and 13 were binocular. Mean vertical deviation was 3.2(delta)for distance and 4(delta)for near. Maximum torsion ranged from 5 degrees (previous surgery) to 24 degrees excylotorsion with a mean of 13 degrees. Thirteen patients had a V pattern. After surgery the mean vertical deviation was 1.5(delta )for distance and 1(delta)for near. Ten patients were symptom free, 8 had reduced diplopia and 5 were unchanged. The worst torsion post-op ranged from 1 degrees of intorsion to 11 degrees of excyclotorsion (mean 4 degrees ). Further vertical muscle surgery was required in 10 (43%) patients. Mean follow-up was 13.5 months.In these patients bilateral modified Harada-Ito procedures successfully reduced torsion and decreased symptoms. Many patients require subsequent surgery to improve other aspects of their motility problem." @default.
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- W1971569464 date "2002-01-01" @default.
- W1971569464 modified "2023-10-18" @default.
- W1971569464 title "Modified Harada-Ito procedure in bilateral superior oblique paresis" @default.
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- W1971569464 doi "https://doi.org/10.1076/stra.10.3.211.8123" @default.
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