Comparison of hang-back and conventional bimedial rectus recession in infantile esotropia.

PURPOSE: To compare surgical outcome of hang-back and conventional bimedial rectus muscle recession in infantile esotropia.

PATIENTS AND METHODS: The charts of 67 consecutive patients with infantile esotropia who underwent bilateral medial rectus muscle from 1990 through 2005 were retrospectively reviewed. Thirty patients were operated by hang-back technique (group 1) and 37 by conventional bimedial rectus recession in which the tendon was sutured directly to the globe (group 2). In each group, the angle of esotropia (PD - prism diopters) before and 6 months after surgery and the success rate (deviation of < or =10 PD) were documented.

RESULTS: Esotropia improved an average of 39.7 (SD 14.9) PD in group 1 (from a preoperative 42.7 (SD 11.6) PD to 3.0 (SD 8.5) PD postoperatively) and 45.5 (SD 19.3) PD in group 2 (from a preoperative 54.3 (SD 16.8) PD to 8.7 (SD 12.1) PD postoperatively) (p = 0.18, independent sample t-test). Success rate (defined as deviation of < or =10 PD at 6 months postoperative examination) was 83.3% in group 1 and 70.2% in group 2 (p = 0.21, Chi-square). Multivariate logistic regression suggests that surgical outcomes are not significantly influenced by age and preoperative angle of esotropia. No complications occurred in both groups.

CONCLUSION: Hang-back technique is as effective as the conventional bimedial rectus muscle recession in correcting infantile esotropia.