Sadia Bukhari, Abdul Rashid Shaikh, Israr Ahmed Bhutto, Maria Nazish Memon, Umair Qidwai.
Conventional Muscle Recession V/S Hang-Loose technique in Patients with true type of Intermittent Distance Exotropia.
Ophthalmol Update Jan ;13(3):178-80.

Objective: To compare the effectiveness, in terms of reduction in postoperative residual deviation, of conventional muscle resection v/s hang-loose technique in patients with divergence excess exotropia Study design: Randomized parallel group study. Place and duration of study: Al Ibrahim Eye Hospital, Karachi, from July 2011 to April 2013. Methodology: Patients having intermittent exotropia (Deviation15-45 prism diopters [PD]) were included in this study, conducted from July 2011 to March 2012, at Al-Ibrahim Eye Hospital, Karachi. Patients with intermittent exotropia were randomly allocated into either bilateral lateral recession group which underwent bilateral lateral recession (maximum up to 10mm) or hang-loose technique group which underwent hang-loose technique. In conventional recession surgery, the lateral rectus muscle was attached directly at the desired scleral site, whereas in the hang-loose recession surgery, the lateral rectus muscle was suspended from the original insertion to the desired scleral attachment site with a double-armed 6-0 polyglactin suture. Final outcome was considered at the end of two months at which achievement of ?10 PD of exotropia was considered as a success. Results: In this randomized group study, 82 patients were included according to inclusion and exclusion criteria. Out of these 82 patients, 45 (54.9%) were male while 37 (45.1%) were female. Mean age of the patients was 17.48 years (± 9.39). Most of the patients, 48 (58.5%) underwent bilateral rectus recession, while the remaining 34 (41.5%) underwent hangloose technique. Mean residual deviation in bilateral lateral rectus recession group after surgery was 7.79 prism diopters (± 8.43), compared to 9.32 prism diopters (± 9.77) mean residual deviation in hang-loose technique group after surgery. Similarly, success rate was also better in bilateral lateral rectus recession group, 89.5 %, compared to 73.53% in hang-loose technique group (p=0.058). Conclusion: Conventional bilateral lateral rectus recession surgery has slightly higher success rate compared to Hang loose technique in cases of intermittent exotropia but the difference between the two techniques in not statistically significant.

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