Observational studyBMC ophthalmology2026
Outcomes of hang-back recession for restrictive strabismus associated with thyroid eye disease.
Observational study in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundTo evaluate the outcomes of hang-back recession applied to mechanically restricted rectus muscles in patients with thyroid eye disease (TED)-related strabismus, focusing on alignment stability and surgical success.
methodsThis retrospective observational study included patients with TED who underwent hang-back recession of mechanically restricted rectus muscles for diplopia and/or restrictive ocular motility. Surgical dose was determined based on preoperative deviation magnitude and intraoperative findings rather than a fixed nomogram, and postoperative alignment outcomes were assessed at standardized follow-up visits.
resultsFourteen patients (17 eyes) were included. Mean age was 48.8 ± 10.2 years, and all patients presented with diplopia. Horizontal deviation (10 eyes) showed a significant reduction at all postoperative time points at both near and distance fixation (p = 0.005), while vertical deviation (8 eyes) also demonstrated significant improvement throughout follow-up (p ≤ 0.012). Improvement was evident from the first postoperative week, with stable alignment achieved by the third postoperative month. No overcorrection occurred after horizontal surgery, and a mild vertical overcorrection (4 prism diopters) was observed in one patient. Based on a success criterion of postoperative deviation within ± 5 prism diopters, surgical success was achieved in 100% of cases, and no reoperation was required.
conclusionsHang-back recession may provide effective and stable correction of TED-related strabismus. This tension-free approach was associated with favorable postoperative alignment and a low incidence of clinically significant overcorrection in the present series. These findings should be interpreted considering the relatively small cohort and the absence of a control group.
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