A novel technique for inferior rectus recession

Birsen Gokyigit, Serpil Akar, Omer Faruk YilmazDepartment of Strabismus, Istanbul Beyoglu Educational and Research Eye Hospital, Istanbul, TurkeyPurpose: To introduce a novel technique of inferior rectus recession operation to allow larger amounts of recession without causing lower lid retraction and to compare this method with the results obtained in standard inferior rectus recession.Material and methods: This study included 20 patients operated on in the authors' clinic. The median age of the patients was 24.5±18.6 (4–73) years and the median follow-up was 9.3±11.8 (3–43) months. Ten patients operated on with the standard method were labeled Group 1 and ten patients operated on with the new method were labeled Group 2. Without exceeding 4 mm, inferior rectus recession to the whole muscle was performed in Group 1 patients. Inferior rectus recession was also performed on patients in Group 2 following the new method. Using a spatula, approximately 10% of the muscle surface fibers were detached intact as a thin layer, and the remaining 90% of deeper fibers were recessed 4–8 mm as planned. Patients' preoperative deviations and lower lid positions were recorded. The same parameters were checked in the first and third month postoperatively. Both groups were evaluated retrospectively by screening their files, and the Mann–Whitney U test was used for statistical evaluation.Results: Lower lid retraction was seen in four patients of Group 1. There was no retraction in Group 2. While there was a need to perform additional vertical muscle procedures for vertical deviations and lower lid retractions in Group 1, it was observed that there was no need for additional procedures in Group 2 patients. There was a statistically meaningful difference between the two procedures (P<0.05).Conclusion: This novel technique was found to be an effective surgical method for permitting more recession without the risk of lower lid retraction.Keywords: inferior rectus recession, lower lid retraction, ophthalmologic surgical procedure