Anchored versus conventional hang-back bilateral lateral rectus muscle recession for exotropia

PURPOSE To compare the results of conventional hang-back and anchored hang-back technique for bilateral lateral rectus muscle recessions in patients with exotropia. METHODS In a prospective, randomized clinical study, 60 patients underwent lateral rectus muscle recession by either conventional hang-back or anchored hang-back technique. Patients were then followed for 6 months; postoperative deviation and complications were compared. Surgery was considered successful if the postoperative deviation was within 10 of orthophoria. RESULTS The mean age of patients was 14.2 +/- 10.3 years (median, 12 years) in the conventional hang-back group and 11.5 +/- 9.3 years (median, 8 years) in anchored group (P = 0.85). The mean preoperative deviation at distance and near between the 2 groups was not statistically significant. The mean postoperative deviation was 8(Delta) +/- 9(Delta) at distance and 7(Delta) +/- 9(Delta) at near in the conventional group and 9(Delta) +/- 8(Delta) at distance and 8(Delta) +/- 8(Delta) at near in the anchored group. (P = 0.48 for distance, P = 0.98 for near). After 6 months, 63% of the conventional group and 60% of the anchored group were within 10 of orthophoria. Complications such as globe perforation, A and V patterns, and vertical deviations did not occur in either group. There were no statistically significant differences in the success rates (P = 0.79) or complications between the 2 groups. CONCLUSIONS The placement of additional posterior scleral sutures to "anchor" the insertion did not improve outcomes in lateral rectus muscle recession surgery. (J AAPOS 2011;15: 532-535)