Bimedial hang-back recession -- outcomes and surgical response.
OBJECTIVE
To report outcomes and identify factors affecting surgical response for constant esotropia using 'hang-back' bimedial rectus recession.


METHODS
Retrospective case series analysis.


METHODS
Patients managed by a single surgeon over a 4-year study period were categorized into esotropia types: infantile, partially accommodative, nonaccommodative and secondary esotropia. Postoperative alignment was compared between types, and regression modelling used to examine factors predicting surgical response.


RESULTS
In all, 95% (18/19) of children with partially accommodative esotropia achieved postoperative deviation <15 prism dioptres from orthotropia, compared to 56% (15/27) of children with infantile esotropia, 69% (11/16) of children with non-accommodative esotropia and all (2/2) of those with secondary esotropia. Surgical response (Delta/mm recession performed) increased with the magnitude of both preoperative deviation (P<0.001) and anisometropia (P<0.001); the effect of deviation on surgical response was reduced by amblyopia (P=0.02). Age at surgery was statistically associated (P=0.002) but had negligible clinical effect on response.


CONCLUSIONS
Surgical response to hang-back recession may be partially predicted by preoperative factors.
Hemmerdinger
C
C
Manchester Royal Eye Hospital, Oxford Road, Manchester, UK.
Rowe
N
N
Baker
L
L
Lloyd
I C
IC
D000065:Accommodation, Ocular; D000367:Age Factors; D017668:Age of Onset; D000550:Amblyopia / Q000150:complications; D015858:Anisometropia / Q000150:complications; D002675:Child, Preschool; D004948:Esotropia / Q000150:complications / Q000601:surgery*; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome