Can an Inferior Oblique recession do the same as Harada-Ito?

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fresnelp@yahoo.com - 22 Jun 2005 06:05 GMT

Hi all,

I have a kind of strabismus called excyclotropia (15 degree tilt). This
is usually corrected by Harada-Ito. However, I hear that this procedure
is difficult. Does anyone know if an Inferior oblique recession would
have the same effect?

Thank you!

Peter

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David Robins, MD - 24 Jun 2005 06:53 GMT

On 6/21/05 10:05 PM, in article
1119416744.870948.187790@g49g2000cwa.googlegroups.com, "fresnelp@yahoo.com"

> Hi all,
>
[quoted text clipped - 6 lines]
>
> Peter

Inferior oblique recession can reduce excyclotropia, but it will also cause
hypotropia (depression) of the ey in primary and in elevation, causing a
vertical misalignment. This procedure would be useful if there is coexisting
over-elevation (hypertropia) with an excyclotropia.

If the problem is exclusively excyclotropia, the the Harada-Ito is the
correct procedure of choice, since it does not influence vertical eye
position usually. It is really not difficult for the strabismus-specialty
surgeon, but is not as easy an an inferior oblique recession. For the
general ophthalmologist, it might be difficult. Strabismus surgeons do these
not infrequently.

You can even do an adjustable Harada-Ito, but the adjusting is a little
difficult. However, you can sometimes adjust these in the operating roo by
observing the fundus torsion on the table.

David Robins, MD
Board certified Ophthalmologist
Pediatric and strabismus subspecialty
Member of AAPOS
(American Association of Pediatric Ophthalmology and Strabismus)

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