ABSTRACT
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(Δ) 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(Δ) ± 9(Δ) at distance and 7(Δ) ± 9(Δ) at near in the conventional group and 9(Δ) ± 8(Δ) at distance and 8(Δ) ± 8(Δ) 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(Δ) 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.
Subject(s)
Exotropia/surgery , Oculomotor Muscles/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Prospective Studies , Sclera/surgery , Suture Techniques , Young AdultABSTRACT
PURPOSE: Anterior transposition of the inferior oblique muscle (ATIO) has been reported to be an effective treatment for dissociated vertical deviation (DVD). In this study, we evaluated the effectiveness of this surgical procedure in patients with DVD alone and in those with DVD with concurrent overactive inferior oblique muscle and compared the results. METHODS: Nineteen eyes with DVD alone (group 1) and 15 eyes with DVD and concurrent inferior oblique overaction (group 2) underwent ATIO. The amount of DVD and inferior oblique overaction before and after the operation was measured and statistically analyzed. RESULTS: The average follow-up time for group 1 and group 2 was 9.4 and 9.0 months, respectively. Of a total of 34 eyes, 7 had DVD of more than 15 prism-diopters (pd) [four eyes from group 1 and three eyes from group 2] in which the residual DVD after surgery was more than 5 pd. However, in the 27 eyes with DVD of 15 pd or less (15 from group 1 and 12 from group 2), the residual DVD after the operation was less than 5 pd. (Fisher's exact test, P = .014). CONCLUSION: ATIO is an effective method for correcting DVD with and without inferior oblique overaction, especially in deviations of less than 15 pd.
