Modified adjustable suture hang-back recession versus conventional adjustable hang back recession in Strabismus cases: A tertiary care hospital based study

Aim: To describe and compare modified hang-back recession with conventional hang-back recession in large angle concomitant exotropia. Methods: A prospective, interventional, double blinded, randomised study on adult patients (>18 years) undergoing single eye recession-resection for large angle (>30Prism Dioptres (PD) constant concomitant exotropia (XT) was conducted between July 2014 to December 2015. Patients in Group M underwent modified hang-back lateral rectus recession (LR) with adjustable knot while in Group C underwent conventional hang-back recession with adjustable knot. Outcome parameters studied were readjustment rate, change in deviation at 6 weeks, complications and need for re surgery at 6 months. Results: The groups were comparable in terms of age and pre operative deviation. The patients with the modified hang back (Group M) fared significantly better (p<0.05) than the conventional hang back (Group C) in terms of lesser need for adjustment, greater correction in deviation at 6 weeks and lesser need for re surgery at 6 months. Conclusion: This modification offers several advantages, significantly reduces re surgery requirement and has no added complication