Comparison of hang-back and conventional recession surgery for horizontal strabismus

Abstract

Purpose: To compare the results of hang-back and conventional recession surgery.

Methods: This randomized, double-blind, matched clinical trial comprised 30 patients with esotropia and 24 with exotropia. All ocular examinations before and at least 1.5 months after surgery were performed by an orthoptist who was unaware of the method of recession. All surgeries were performed by the same surgeon.

Results: In patients with esotropia, deviation improved from 31+/-9 prism diopters (delta) preoperatively to 7+/-6 delta postoperatively for hang-back recession (n=15) and from 41+/-14 delta to 6+/-6 delta for conventional recession (n=15). Postoperative horizontal deviation was >10 delta in 40% of patients who underwent hang-back recession and 20% of patients who underwent conventional recession (P<.8). In patients with exotropia, deviation improved from 28.9+/-9 delta preoperatively to 0.5+/-11 delta postoperatively for hang-back recession (n=12) and from 29+/-8 delta to 6+/-6 delta for conventional recession (n=12). Postoperative horizontal deviation was >10 delta in 24% of patients who underwent hang-back recession and 17% of patients who underwent conventional recession (P<.2). Mean follow-up was 7 months.

Conclusion: Hang-back recession is an alternative to conventional rectus muscle recession, especially in children who have smaller globes and patients with myopia or collagen vascular diseases.