Efficacy of using laser assisted adjustable suture in the management of residual angle exotropia

Abstract

To assess the efficacy of using argon laser suture lysis of adjustable sutures used in strabismus surgery in the management of residual exotropia following surgery for intermittent exotropia. A prospective interventional study was conducted on 30 patients with basic type of intermittent exotropia. Sixty eyes were included from November 2018 to December 2019. All patients were operated on with Ripcord adjustable sutures under general anesthesia. On the first day postoperatively, if alignment was satisfactory (within 10 DP), the ripcord suture was kept in place. If there was residual exotropia more than 10 DP, suture can be cut in less than five applications by argon laser lysis and the muscle retracts posteriorly, producing additional recession of the muscle. Thirty patients were enrolled with ages ranging from 15 to 47 years and an average of 25.93±10.5 years. The mean preoperative angle was 44.3±8.8 DP, ranging from 25 to 60 DP. There was no postoperative significant residual angle in 12 patients (40%) immediately after the operation and throughout the follow-up period of 3 months but there were 18 patients (60%) with postoperative significant residual angle and argon laser suture lysis was done for them, then they were followed-up for 3 months.