Comparison of the results of the modified and classical bi-medial hang-back recession in infantile esotropia.

PURPOSE: Bi-medial rectus recession, which can also be performed using a hang-back technique, is one of the surgical treatment options for infantile esotropia (IE). This study has modified the surgical approach, with outcomes compared to the traditional hang-back technique.

METHODS

The bi-medial recession was performed with a modified hang-back technique in 120 IE patients and with a traditional hang-back technique in 88 cases. Surgical outcomes were reviewed and compared retrospectively.

RESULTS

The patients in the two groups were compared in terms of surgery time, inferior oblique weakening surgery, and the presence of refractive error. The differences between pre-operative and postoperative first-month, sixth-month, and first-year degrees were statistically significant (p < 0.001).

CONCLUSIONS

This modified novel technique aims to avoid unwanted muscle movement in the horizontal and vertical axes and a gap in the middle of the recessed muscle, as seen in the traditional hang-back technique. Further, the modified technique resulted in less over- and under-correction as well as alphabetic pattern deviation.