Long-term results of hang-back medial rectus recession

Purpose: To report long-term results with the hang-back technique for medial rectus muscle recession. Methods: Medical records of 341 consecutive patients who underwent unilateral or bilateral hang-back medial rectus recession were reviewed. The amount of recession was based on the size of the esotropia as measured at near fixation. Patients were divided into two groups according to age at onset of esotropia: patients <1 year comprised group 1 and patients greater than or equal to1 year comprised group 2. Surgical outcomes were analyzed for all patients included in the study. Results: A total of 189 patients met the inclusion criteria. In group I patients (n=32), average deviation improved from 48.3 prism diopters (PD) preoperatively to 1.1 PD postoperatively. Eleven patients required a second procedure: 9 with recurrent esotropia and 2 with consecutive exotropia. Average time to second procedure was 27.4 months. In group 2 patients (n=157), average deviation improved from 29.6 PD preoperatively to 1.1 PD postoperatively. Twenty-one patients required a second procedure: 20 with recurrent esotropia and 1 with consecutive exotropia. Average time to second procedure was 22.7 months. Conclusion: The hang-back technique represents a safe, effective alternative to conventional medial rectus recession.