Comparation of wound healing after starabismus surgery with radiosurgery versus conventional surgical techniques in a rabbit model

One of the most serious complications after strabismus surgery is the formation of adhesions. Postoperative adhesion and tissue scarring may result in unsatisfactory, unpredictable surgical outcomes and ocular motility dysfunction, particularly in cases that involve complicated operations. These adhesions may originate because of improper tissue handling, excessive bleeding or cauterization, extrusion of orbital fat into the surgical field or postoperative infections.Surgeons have traditionally used the scalpel for skin incisions and fine subcutaneous dissection because of its precision and favorable healing profile. However, scalpel incisions result in bleeding that obscures the surgical field. For this reason, the investigators have made plenty of studies, regarding the methods alternative to the conventional scalpels. The EC and the lasers come in the lead of these methods. Conventional EC has been clinically available for more than a half century and today is in widespread use as an alternative to the scalpel to reduce bleeding during surgery and efforts have been made to reduce surrounding tissue damage created by heat dissipated from the incision. Radiosurgery is an electrosurgery instrument which avoids bleeding while making incisions and deep tissue dissections. Its efficacy and reliability has been established with various surgical techniques. It is also used in various ophthalmic operations. In this study; RC is aimed to be used for muscle incisions and the RC had been compared with conventional scissors(W) and the conventional electrosurgery (K) about the general wound healing process, fibrosis and the instrument performance.This study was held in Gazi University Test Animal Laboratory. New Zealand White rabbits were used for this study.Radiosurgery was the most effective tool for producing hemostasis and produced minimal tissue discoloration, sticking and thermal injury to surrounding tissues but there were no statistically significant difference compared with the K group. Histolojical scoring for infiltration of acute and late inflammatory cells was equivalent between the three groups. Significantly higher fibrosis scores was noted at 3 weeks for W group and least for RC group. Macrophages identified as CD68+ cells were highest at W group but there were no statisticaly significant difference.Strabismus surgery with radiosurgery provides atraumatic, sterile muscle cutting and electrosurgical-like hemostasis, resulting in minimal bleeding, tissue injury and scar formation. So that it is posible to reduce surgical time and to enhance comfort to the surgeon.