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To determine the precise site of reattachment of recessed muscles, 4-mm conventional and hang-back recessions of the inferior rectus muscle were performed in 18 albino rabbits. Six weeks later, the distance from the anterior border of the reattached muscle to the insertion was measured both grossly and microscopically. In all cases the operated muscles had advanced minimally from the site of surgical placement. Gross observation showed that the mean forward creep was significantly greater for those rabbits which underwent hang-back recession (1.81 +/- 0.67 mm) than for those that were submitted to the conventional technique (0.83 +/- 0.38 mm). Measurements done on histological sections revealed that the mean distance of the anterior border of the muscle fiber from the reference suture was larger for conventional recession (2.73 +/- 0.75 mm) than for hang-back recession (1.91 +/- 0.72 mm).

Twenty-four patients who underwent surgery to correct consecutive exotropia that developed iatrogenically after surgical overcorrection were studied retrospectively. All patients underwent single or bilateral advancement of the medial rectus muscle to the original muscle insertion. The mean preoperative exodeviation was 26.7 prism diopters at distance and 3S.2 Δ at near. Postoperatively, in cases receiving advancement of a single medial rectus, the mean amount of correction was 23.2 Δ at distance and 29.6 Δ at near. In cases receiving bilateral medial rectus advancement, the mean amount of postoperative correction was 26.3 Δ at distance and 39.8 Δ at near. Adduction deficiency was normalized in five patients (71%), while convergence insufficiency was improved in only nine patients (45%) after surgery. Twelve (50%) patients had binocular single vision at distance on a normal or abnormal basis as determined by the Bagolini lens test.

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