Purpose: To compare surgical outcomes and astigmatism induced by Hang-back and conventional recession surgery in horizontal strabismus.
Methods: In a randomized, double blind, prospective trial, 40 patients of horizontal strabismus, (18 exotropia and 22 esotropia) were randomized into 2 groups according to the type of recession procedure performed. All ocular examinations were done pre and post-operatively including manual and automated keratometry, assessment of angle of deviation was carried out by a certified orthoptist. All patients were followed for a mean duration of 6 months.
Results: Among esotropia success rate (defined as post-operative deviation of < 10 PD 6 months post operatively) was 80 % in patients with Hang-back recession and 84 % in patients with conventional recession (p=1). For exotropia success rate was 60 % in patients with hang-back recession and 75 % among patients of conventional recession (p>0.6). 90 % of eyes operated with conventional recession technique showed significant changes in average keratometry readings (defined as change of > 0.50 D), while for eyes operated by Hang-back technique only 37 % showed same changes (p<0.002). Surgeons comfort score using visual analogue scale was also compared.
Conclusion: Hang-back recession is an effective alternative to conventional recession with an added advantage of decreased amounts of surgically induced astigmatism, especially in children with smaller globes, poor exposure and high myopia.
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Author Name: Ishan Yadav, V.P. Singh, Prashant Bhushan, Rajendra P. Maurya, M.K. Singh.
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Keywords: Esotropia, Exotropia, conventional recession, Hang-back recession, keratometry.