Anchored absorbable versus conventional nonabsorbable sutures in hang-back medial rectus muscle recession for large-angle esotropia

Purpose The aim of this study was to compare the clinical safety and efficacy of the anchored hang-back technique (HBT) to the HBT using nonabsorbable sutures in bilateral medial rectus recession (BMR) for large-angle esotropia (ET). Design This is a prospective comparative interventional study. Patients and methods The study included 81 patients with concomitant ET who were indicated for BMR of at least 6 mm. The patients were randomly assigned to have either (a) anchored HBT-BMR using absorbable 6–0 polyglactin 910 suture or (b) conventional HBT-BMR using nonabsorbable 6–0 polyester suture. Postoperatively, angles of deviation were measured for both near and far at 1 week and at 2 and 6 months. Success was defined as alignment within 10 prism diopters (PD) of orthotropia by the end of 2 months. Results Nonabsorbable HBT was used in 42 patients, whereas the anchored HBT was used in 39 patients. The mean preoperative angles of deviation for near and far were 60.9 and 58.7 PD, respectively, in the nonabsorbable group, compared with 61.7 and 58.8 PD, respectively, in the anchored group (P>0.05). By the sixth postoperative month, the mean angles for near and far in the nonabsorbable group were 8.1±0.6 PD of exotropia (XT) and 8.3±1.2 PD of XT, compared with 9.9±0.03 and 9.5±1.2 PD of XT in the anchored group, respectively. Repeated measures analysis of variance showed insignificant differences in the near and far angles between both groups. The success rate was 92.8% (39/42) in the nonabsorbable group compared with 89.7% (35/39) in the anchored group (P=0.32). Conclusion Anchored HBT was as safe and effective as nonabsorbable HBT in BMR for large-angle ET.