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Randomized Controlled Trial
. 2017 Nov;65(11):1183-1186.
doi: 10.4103/ijo.IJO_326_17.

Modified adjustable suture hang-back recession: Description of technique and comparison with conventional adjustable hang-back recession

Siddharth Agrawal  1 , Vinita Singh  1 , Ankur Yadav  1 , Sonal Bangwal  2 , Vishal Katiyar  1
Affiliations
Randomized Controlled Trial

Modified adjustable suture hang-back recession: Description of technique and comparison with conventional adjustable hang-back recession

Siddharth Agrawal et al. Indian J Ophthalmol. 2017 Nov.

Abstract

Purpose: This study aims to describe and compare modified hang-back recession with the conventional hang-back recession in large angle comitant exotropia (XT).

Methods: A prospective, interventional, double-blinded, randomized study on adult patients (>18 years) undergoing single eye recession-resection for large angle (>30 prism diopters) constant comitant XT was conducted between January 2011 and December 2015. Patients in Group A underwent modified hang-back lateral rectus recession with adjustable knot while in Group B underwent conventional hang-back recession with an adjustable knot. Outcome parameters studied were readjustment rate, change in deviation at 6 weeks, complications and need for resurgery at 6 months.

Results: The groups were comparable in terms of age and preoperative deviation. The patients with the modified hang back (Group A) fared significantly better (P < 0.05) than those with conventional hang back (Group B) in terms of lesser need for adjustment, greater correction in deviation at 6 weeks and lesser need for resurgery at 6 months.

Conclusion: This modification offers several advantages, significantly reduces resurgery requirement and has no added complications.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a)The muscle is isolated on a muscle hook. (b) Border locking suture passes are made with vicryl 6’0’ and muscle is disinserted. (c) Sclera is marked along the borders of original muscle at desired length. (for example to perform a 6+4 mm recession, markings are done 6mm from original insertion) (d) Small partial thickness scleral bites are taken at the marked sites and needles are advanced towards muscle stump. (e)The needles are then passed through the episclera & muscle stump and the muscle is brought anteriorly (f) The muscle is then allowed to hang back for 4 mm and a bow type adjustable knot is tied
Figure 2
Figure 2
Small partial thickness bites are taken at the marked site
Figure 3
Figure 3
The sutures are passed at original insertion site with a bow type adjustable knot to achieve modified hang-back recession
See this image and copyright information in PMC

References

    1. Agrawal S, Singh V, Singh P. Adjustable recessions in horizontal comitant strabismus: A pilot study. Indian J Ophthalmol. 2015;63:611–3. - PMC - PubMed
    1. Nihalani BR, Hunter DG. Adjustable suture strabismus surgery. Eye (Lond) 2011;25:1262–76. - PMC - PubMed
    1. Repka MX, Guyton DL. Comparison of hang-back medial rectus recession with conventional recession. Ophthalmology. 1988;95:782–7. - PubMed
    1. Odehnal M, Malec J, Hlozánek M. Hemi-hangback recession (retroposition) of extraocular muscles. Cesk Slov Oftalmol. 2004;60:356–61. - PubMed
    1. Nabie R, Azadeh M, Andalib D, Mohammadlou FS. Anchored versus conventional hang-back bilateral lateral rectus muscle recession for exotropia. J AAPOS. 2011;15:532–5. - PubMed

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