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.