A new modfied anchored suspension-recession (so-called "hang-back" technique for high risk strabismus surgery.

PURPOSE: To intruduce a new method for rectus muscle recession in order to minimize the riSk of a lost or slipped muscle and scleral perforation and compare it with the conventional method.

PATIENTS AND METHODS: In a prospective study between May 2002 and December 2006, 69 patients underwent recession with the modified technique, and 50 patients underwent recession with the conventional method. We compared the results of strabismus surgery in these non-randomized series with esotropia or exotropia treated with conventional surgery with the modified technique surgery. Patients in the modified technique group were high risk patients that had large angle recession, thin sclera or less exposure sugical field.

RESULTS: Surgical outcomes were not significantly different in the two treatment groups that based on their findings had been classified into four subgroups. No complications such as globe penetration, muscle slippage or lost muscle were observed during the follow up period of 12 months.

CONCLUSIONS: It seems that the modified method introduced in this study can reduce the complications and risks involved in conventional and suspension-recession methods and it is safe and effective for muscle recession. It can decrease the risk of globe perforation since the sclera behind the insertion is penetrated only superficially because of anchor suturing to the muscle insertion stump, and the possibility of lost or slipped recessed muscles would be minimized.