Laser-Assisted Adjustable Suture Technique in Strabismus Surgery

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, Wes...

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Autores principales:	Hannon AA, Elalfy M, Elborgy ES, Hegazy SM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	recession laser-assisted adjustable suture strabismus lateral rectus muscle. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5b0a5d38418644a2a31a2a104f148435
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spelling	oai:doaj.org-article:5b0a5d38418644a2a31a2a104f1484352021-12-02T15:12:05ZLaser-Assisted Adjustable Suture Technique in Strabismus Surgery1177-5483https://doaj.org/article/5b0a5d38418644a2a31a2a104f1484352020-12-01T00:00:00Zhttps://www.dovepress.com/laser-assisted-adjustable-suture-technique-in-strabismus-surgery-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ahmed 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 ahmedhannon2020@gmail.comPurpose: 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 muscleHannon AAElalfy MElborgy ESHegazy SMDove Medical Pressarticlerecessionlaser-assisted adjustable suturestrabismuslateral rectus muscle.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4347-4354 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	recession laser-assisted adjustable suture strabismus lateral rectus muscle. Ophthalmology RE1-994
spellingShingle	recession laser-assisted adjustable suture strabismus lateral rectus muscle. Ophthalmology RE1-994 Hannon AA Elalfy M Elborgy ES Hegazy SM Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
description	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 ahmedhannon2020@gmail.comPurpose: 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
format	article
author	Hannon AA Elalfy M Elborgy ES Hegazy SM
author_facet	Hannon AA Elalfy M Elborgy ES Hegazy SM
author_sort	Hannon AA
title	Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
title_short	Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
title_full	Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
title_fullStr	Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
title_full_unstemmed	Laser-Assisted Adjustable Suture Technique in Strabismus Surgery
title_sort	laser-assisted adjustable suture technique in strabismus surgery
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/5b0a5d38418644a2a31a2a104f148435
work_keys_str_mv	AT hannonaa laserassistedadjustablesuturetechniqueinstrabismussurgery AT elalfym laserassistedadjustablesuturetechniqueinstrabismussurgery AT elborgyes laserassistedadjustablesuturetechniqueinstrabismussurgery AT hegazysm laserassistedadjustablesuturetechniqueinstrabismussurgery
_version_	1718387629308772352

Laser-Assisted Adjustable Suture Technique in Strabismus Surgery

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