====== Harada-Ito Procedure ======

===== Purpose =====
  * Strengthen Incylotorsion effect of the Superior Oblique without affecting vertical alignment 
  * Most useful with a functioning superior oblique and excyclotorsion present
  * Can create 10-15 degrees of incyclotorsion
  * The effect may wain 20-30% with time 

===== Description =====
Transpose the anterior 1/3 to 1/2 of the superior oblique tendon fibers to the superior border of the lateral rectus muscle. Fixate the tendon 8 mm posterior to and 2 mm superior to the superior border of the lateral rectus muscle.  Tightening only the radially oriented fibers will avoid a significant change in vertical deviation but there may be an exoshift in down-gaze.\\
{{:harada-ito.png?512|}}

===== References =====
=== Book Chapters ===
[[https://childrenseye.org/filerun/FileRun/wl/?id=aHC4KLmrtuYYN8q8Xe3qwguO8f4eBOCy|Harada-Ito Procedure In Clinical Strabismus Management, Principles and Surgical Techniques. pages 469-473 by Rosenbaum and Santiago, 1999]]\\
[[https://childrenseye.org/filerun/FileRun/wl/?id=Z6wVoWmaEh9GwN0aBbYFcl8fTCanpqSs|Harada-Ito Procedure in Strabimus Surgery and its Complications. pages 122-124. Coats and Olitsky, 2007]]

=== Journal Articles ===

[[https://childrenseye.org/filerun/FileRun/wl/?id=hjhBQyvkzmY0yyZXFI5eDjTWUWrDj1Uv|Outcomes of Harada-Ito surgery for acquired torsional diplopia. Bradfield et al. 2012]]\\
[[https://childrenseye.org/filerun/FileRun/wl/?id=Uap9HcJmIMRl5KBxPJrF3CkMtLAVxEuy|Adjustable Harada-Ito Procedure. Metz & Lerner 1981]]\\
[[https://childrenseye.org/filerun/FileRun/wl/?id=K8a04gA8FZ5JpyDt37u1uPIYCrNFieii|Long-Term Torsion Effect of the Adjustable Harada-Ito Procedure. Nishimura & Rosenbaum 2002]]

{{tag>strabismus_surgery}}