Abstract
PURPOSE:Bimedial rectus recession is one of the surgical treatment options for infantile esotropia. It is mainly performed with the Hang-Back technique, which has undesirable side effects. In this study, this technique has been modified, and its results are discussed.METHODS:The files of 120 patients followed with the diagnosis of infantile esotropia and treated bimedial rectus muscle recession using the modified Hang-Back technique were reviewed retrospectively. Cases were evaluated by the time of surgery, coexistence with inferior oblique muscle weakening surgery, and presence of refractive error. The factors investigated on the results of surgical treatment were determined as age, gender, amount of hyperopic refractive error, application age, amount of horizontal deviation, amount of recession, stereopsis, fusion, age of surgery.RESULTS:When the cases were divided into subgroups which were the time of surgery, the operation performed with inferior oblique weakening surgery and presence of refractive error; the difference between preoperative and postoperative 1st month, 6th month, and 1st-year angle of deviation was statistically significant in all three groups (p < 0.001).CONCLUSION:This novel technique aims to prevent unwanted movement of the muscle in the horizontal and vertical axis and a gap in the middle of the recessed muscle, seen in the classical Hang-Back technique. The difference between the preoperative and postoperative angle of deviation was statistically significant. Also, over and under-correction and the development of alphabetic pattern deviation were less common in our modified technique.
Bimedial rectus muscle elongation versus bimedial rectus muscle recession for the surgical treatment of large-angle infantile esotropia