Comparison of hang-back medial rectus recession with conventional recession

Hang-back recession is commonly used for adjustable strabismus surgery and surgery for dissociated vertical deviation. The authors have begun to use the hand-back technique for routine recessions as well, to simplify the procedure and to lessen the risk of scleral perforation. In 49 consecutive children undergoing conventional bilateral medial rectus recession and 31 consecutive children undergoing hang-back recession, the success rate (+/- 10 prism diopters [PD]) was 80% in the conventional group and 74% in the hang-back group at 6 weeks. The dose-response curves were nearly identical. These results confirm that hang-back recessions for infantile and acquired esotropia are a predictable alternative to conventional strabismus surgery.