Abstract
ABSTRACT Purpose Fell’s modification of the Harada–Ito (HI) procedure is often used to tackle subjective torsion usually following superior oblique palsy. There is limited published data on the longer-term outcomes and the effect on horizontal incomitance of the procedure. The purpose of this study is to report on the medium to long-term outcomes of the HI procedure. Materials and methods A retrospective review of 20 patients who had all undergone a single surgeon modified HI procedure to correct subjective torsion was undertaken. Follow-up data were analyzed in relation to stability of torsion measurements, the effect on vertical incomitance of horizontal deviation and the final treatment outcome. Results There was a significant reduction in median maximum torsion from preoperative to immediately post-op (p < .01) and there remained a significant difference in maximum torsion from preoperative measurement at both the 3-month (p = .02), and 12-twelve month (p = .01) follow-up. HI had a significant effect on associated V-pattern esotropia (p < .05). Conclusion The HI procedure is effective in eliminating subjective torsion initially and reducing incomitant horizontal deviation; however, regression toward preoperative torsion measurement occurs after time.
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