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


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.


CONCLUSIONS
Hang-back technique is as effective as the conventional bimedial rectus muscle recession in correcting infantile esotropia.
Spierer
Oriel
O
Ophthalmology Department, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel. oriels1@yahoo.com
Spierer
Abraham
A
D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology