TITLE:
Modified Harada-Ito Procedure in Acquired Superior Oblique Palsy with Exotropia
AUTHORS:
Sangeetha Tharmathurai, Ahmad Tajudin Liza-Sharmini, Qamaruddin Fazilawati
KEYWORDS:
Modified Harada-Ito, Superior Oblique Palsy, Exotropia, Strabismus
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.6 No.4,
November
9,
2016
ABSTRACT: Superior oblique palsy is the most common isolated cranial nerve palsy and is commonly
associated with exotropia. Modified Harada-Ito procedure can be used to
correct excyclotorsion in symptomatic patients. We report a case of acquired superior
oblique palsy with exotropia undergoing modified Harada-Ito procedure. A 33
years old man presented with torsional diplopia. On examination there was 10 degrees
of left excyclotorsion on double Maddox rod with 25-diopter of exotropia on
primary gaze and 20-diopter on lateral gaze suggestive of lateral incomitancy. He
underwent a Fells modification of Harada-Ito procedure with bilateral rectus recession.
Three months postoperative, he was orthophoric. Modified Harada-Ito procedure
is a successful procedure in overcoming torsional diplopia. It is important to
identify lateral incomitancy to prevent overcorrection of the horizontal deviation.