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Park, Shin, and Kim: Surgical Results of Modified Harada-Ito Operation for Excyclotorsion
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(4): 565-571.

Published online: 17 April 2012

DOI: https://doi.org/10.3341/jkos.2012.53.4.565

Surgical Results of Modified Harada-Ito Operation for Excyclotorsion

Ka Hee Park, MD, Jin Hee Shin, MD, So Young Kim, MD

Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

Address reprint requests to So Young Kim, MD. Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, #31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 330-721, Korea. Tel: 82-41-570-2260, Fax: 82-41-576-2262, ophdrkim@schmc.ac.kr

Received 3 January 2011       Accepted 7 March 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

We evaluated the efficacy of the modified Harada-Ito operation for excyclotorsion in acquired superior oblique palsy patients after trauma.

Methods

This study represents a retrospective review of 10 eyes in 9 patients who were surgically treated for excyclotorsion. Cyclotorsion was measured with the double maddox-rod test and fundus photographies preoperatively and postoperatively.

Results

The median measured change in excyclotorsion before and after the surgery in the primary gaze was reduced from 15.67 ± 6.00 to 4.78 ± 3.42 according to fundus photographies and from 12.30 ± 6.27 to 2.45 ± 3.73 according to the double maddox-rod test. Subjective and objective changes in excyclotorsion werer not significantly different.

Conclusions

The Modified Harada-Ito operation is an effective treatment for correcting excyclotorsion. Although not statistically significant, the amount of excyclotorsion on fundus photography is exaggerated. This point should be considered to achieve effective surgery.

Keywords: Double Maddox-rod test, Excyclotorsion, Fundus photography, Modified Harada-Ito operation, Superior oblique palsy

Figures and Tables

Figure 1
The measurement of disc foveal distance and angle. We set the optic disc center at the point that the two center lines cross each other."θ" is the angle of the optic disc center and the fovea. θ = tan (b/a).
jkos-53-565-g001
Figure 2
Pre- and postoperative fundus photographs of a patient with right superior oblique muscle palsy. (A) Foveal position of the left eye is within normal range but there is excyclotropia in the right. (B) Foveal position of the right eye is within normal range but with equal amounts of excyclotropia in the left.
jkos-53-565-g002
Table 1
Baseline characteristics of superior oblique muscle palsy patients
jkos-53-565-i001

Values are presented as mean ± SD or number.

F/U = follow up; IOP = intraocular pressure.

Table 2
Pre-operative ocular findings of the patients
jkos-53-565-i002

No. = number of patient; Dx = diagnosis; VD = vertical deviation; HD = horizontal deviation; ED at 1° = excyclodeviation at primary position; L = left; B = both; R = right; SOP = superior oblique muscle palsy; RH = right hypertropia; LH = left hypertropia; XT = exotropia.

Table 3
Change of torsion angle of deviated eye in the primary gaze (degree)
jkos-53-565-i003

*Tested by Mann-Whitney test.

Table 4
Post-operative ocular findings of the patients
jkos-53-565-i004

No. = number of patient; Dx = diagnosis; VD = vertical deviation; HD = horizontal deviation; ED at 1° = excyclodeviation at primary position; L = left; B = both; R=right; SOP = superior oblique muscle palsy; RH = right hypertropia; LH = left hypertropia; XT = exotropia.

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