130108 Bridging the gap: transforming ROP screening through systematic referral pathways in a tertiary NICU in a low- to middle-income country

Unilateral full surgery provided a mean improvement of 6i ncyclotorsion in primary position, and 7.75in worst gaze position.This represents improvements of 0.46and 0.54per mm of advancement.Partial surgery provided 5.68and 6.53o f total improvement respectively.These were similar among the different groups, however restrictive causes appeared to regress more rapidly.35 patients (47.9%) had resolution of diplopia in at least primary position, although most had persistent diplopia in extreme gaze.No patients with restrictive strabismus had resolution of diplopia after Harada-Ito alone.7 patients (9.6%) developed iatrogenic Brown syndrome, while 1 developed scarring requiring surgical release.24 patients (32.9%) had subsequent surgery for ongoing diplopia.Modified Harada-Ito surgery is an effective treatment for torsional diplopia.This is the largest outcome study to date and suggests more modest improvements than some previous studies.The surgical effect may be more transient in restrictive cases.Serious complications are rare, but further surgery is common, particularly where horizontal or vertical diplopia coexists.