Infrared Dye Enhanced Diode Laser Extraocular Muscle Resection– A New Method for Strabismus Surgical Correction

Abstract

Abstract: : Purpose: To study the combined effect of diode laser and indocyanine green (ICG) on rectus Extraocular muscles (EOMs) to create local shortening effect. Methods: A cw–diode laser (810nm) system with a 1.5m–long silica fiber diopexy probe was used on five human cadaver EOM rectus tissues. The laser energy was delivered by gently pressing the probe against the EOM surface with a 0.6mm in diameter laser spot size. Five mm of EOM No. 1 was painted with a 0.02% ICG dye using soaked wekcel sponge. Three rows of laser treatment spots adjacent to each other were created on the 3mm of the painted area with settings of 1W 0.5sec. The EOM No 2 underwent the same treatment with settings of 2W 0.5 sec. The EOM No 3 underwent 2W 2sec laser treatment. The EOM No 4 and 5 were used as controls with no use of ICG dye. Results: In the eyes treated with ICG dye, the laser applications produced 3mm muscle shrinkage with white to yellowish surface color change. The EOM No 2 and No 3 had similar contracture effects. The EOM No 1 had minimal color change without any shrinkage. The eyes No 4 and 5 showed no color change or shrinkage. Conclusions: Diode laser coupling with ICG–treated EOM tissues lead to contracture of Extraocular muscles. A new method of ICG–enhanced laser modulation of EOMs would be an alternative approach to the traditional incisional resection method in surgical management of certain strabismus conditions.

Keywords: strabismus: treatment • strabismus • strabismus: etiology