Clinical Ophthalmology (Dec 2020)
Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
Abstract
Ahmed A Hannon,1 Mohamed Elalfy,2 Ebrahim S Elborgy,3 Sherif M Hegazy3 1Pediatric Ophthalmology and Strabismology Department, Research Institute of Ophthalmology, Cairo, Egypt; 2Cornea and Refractive Department, Research Institute of Ophthalmology, Cairo, Egypt & Queen Victoria Hospital, West Sussex, UK; 3Retina Department, Research Institute of Ophthalmology, Cairo, EgyptCorrespondence: Ahmed A HannonPediatric Ophthalmology and Strabismology Department, Research Institute of Ophthalmology, Cairo, EgyptTel +201000101743Email [email protected]: The aim of this study was to assess the efficacy and safety of a new technique (argon laser-assisted lysis of the adjustable suture) in strabismus surgery.Patients and Methods: Recession of lateral rectus muscle was done and was secured to the sclera at the predetermined recession position after suspending it 1.5– 2.5 mm farther. A 10-0 nylon suture was placed at the original insertion site, passed under the previously tied muscle suture knot, and tied, advancing the muscle to the new scleral insertion. Postoperatively in the same day of surgery, if the targeted slight overcorrection was not achieved, a topical anesthetic was given, and argon laser was used to cut the nylon suture providing additional muscle recession.Results: Forty-two patients with exotropia were included: 11 children and 31 adults. Eleven (26.2%) patients became orthophoric immediately following muscle recession. Thirty-one (73.8%) patients were undercorrected with a mean residual angle of 8.2± 3.3 pd. After laser-assisted release of the suture, 12 (28.6%) patients were orthophoric, with 4 (9.5%) patients still undercorrected and 26 (61.9%) patients overcorrected. By the end of 6 months postoperatively, the overall success rate of the procedure was 88.1%, with only 5 (11.9%) patients with exotropia.Conclusion: The laser-assisted adjustable suture technique had an overall success rate of 88.1% with only 11.9% of the patients showing exotropia. The technique can help achieve successful alignment.Keywords: recession, laser-assisted adjustable suture, strabismus, lateral rectus muscle
