Journal of American Association for Pediatric Ophthalmology and Strabismus
Major articleComparison of Modified Anchored “Hang-Back Technique (HBT)” With Conventional HBT in Bimedial Rectus Recession
Section snippets
Data Collection and Outcome Measure
Consecutive patients younger than the age of 16 who underwent bimedial rectus recession during 1999 and 2000 with at least 6 months of postoperative follow-up period were included in this retrospective study. In 1999, all patients had operations performed with the conventional HBT, whereas those patients in 2000 underwent with the modified technique. Some of the patients also had an additional procedure, such as vertical transposition of horizontal recti, conjunctival recession, and inferior
Results
There were 39 patients in the conventional HBT group and 43 in the modified group who met our inclusion criteria. The mean age, sex, onset, and presentation of strabismus and timing of surgery are summarized in Table 2. Of all the patients, 64.1% (25/39) in the conventional HBT group and 67.4% (29/43) in the modified HBT group required spectacle correction for hypermetropia, respectively. Preoperatively, 18 of 39 (46.2%) were found to be amblyopic in the conventional group and 21 of 43 (51.2%)
Discussion
Consecutive exotropia is a common problem after esotropia correction surgery. The rate varies from 4% to as high as 38%.14, 15, 16, 17 A higher rate of consecutive exotropia was shown to be associated with surgery in patients younger than 7 months of age,17 amblyopia,18 the presence of preoperative A or V patterns, high hypermetropia, or postoperative limitation on adduction.18, 19, 20 In our study, none of these factors was found to be contributory apart from postoperative limitation on
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