Hang-Back Technique versus Conventional Lateral Rectus Recession in Exotropia

Background: Exotropia is a type of eye misalignment. About 90 % of all exodeviations are intermittent exotropia. Management options are non-surgical as correction of refractive error and surgical, here we discussed two surgical techniques: the conventional recession and the Hang-back recession. This study evaluated the result of both techniques in management of exotropia and investigate the longitudinal change in the lateral rectus muscle insertion by AS-OCT imaging of the muscle new insertion site.

Methods: The prospective randomized study included 40 eyes with exotropia. All cases underwent two types of surgery (the conventional recession and the Hang-back recession) and complete ophthalmological and strabismus examination before and after surgical treatment and completed six months follow up at one day, one week, one month, three months, six months.

Results: The success rate for conventional recession technique was 85%. There was no consecutive esotropia as a complication, but a long period of follow up may show delayed consecutive esotropia. There were no significant complications as slipped muscles or infection.

Conclusions: Conventional recession and hang back technique are two surgical options for lateral rectus muscle recession, results of both techniques are compared. The result showed that conventional recession technique success rate is higher than the hang back technique. Our study showed the effectiveness of both techniques as there were no cases that showed limitation of abduction.