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Histologic and Immunohistochemical Evaluation of Radiosurgery in Strabismus Surgery in a Rabbit Model
Demet Yolcu1, Ahmet M Hondur2, Nalan Akyürek3
1Department of Ophthalmology, University of Health Sciences, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Purpose:
The aim of this study was to evaluate the use of monopolar radiosurgery (MRS) assisted strabismus surgery and to compare its histologic and immunohistochemical wound healing outcomes with conventional surgery.
Methods:
Superior rectus muscle resection was performed on 30 white rabbits with three different surgical muscle cutting techniques: monopolar radiosurgery (MRS group), conventional scissors preceded by bipolar electrocautery (BEC group), and conventional scissors with no cauterization (control group). Degree of tissue injury, bleeding, inflammation, and fibrosis, as well as wound healing rate (CD68+ cell number), were evaluated.
Results:
In CS group, hemorrhage scores were significantly higher than those in the other groups (MRS group: Z = 5.182; p < 0.001 and BEC group: Z = 4.463; p < 0.001) and MRS group had lower scores than BEC group; however, the difference was not significant (Z = 1.423; p = 0.211). The tissue injury score in BEC group was higher when compared with MRS, and the difference was statistically significant (p = 0.028). Median inflammation scores at days 1 and 21 were lowest in MRS group, but the difference was not statistically significant among groups (day 1; p = 0.115, day 21; p = 0.095). The median fibrosis score was higher in the control group, when compared with MRS, and the difference was statistically significant (muscle-sclera; p = 0.011 and muscle-conjunctiva: p = 0.003). The macrophage score (number of CD68+ cells) was lowest in CS group; however, the difference was not significant (p = 0.657).
Conclusions:
Monopolar radiosurgery is a novel method for strabismus surgery and provides equivalent hemostasis effects and wound healing properties, compared with conventional methods, and enhances surgeon comfort, as muscle incisions are made in one step with clean surgical area.
Insights
Monopolar radiosurgery (MRS) offers comparable hemostasis and wound healing to conventional strabismus surgery. This novel method enhances surgeon comfort by providing a cleaner surgical field during muscle incisions.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Histopathology
Background:
- Strabismus surgery traditionally involves muscle cutting techniques with varying degrees of tissue trauma and bleeding.
- Evaluating novel surgical methods like monopolar radiosurgery (MRS) is crucial for improving patient outcomes and surgical efficiency.
Purpose of the Study:
- To assess the efficacy of monopolar radiosurgery (MRS) in strabismus surgery.
- To compare the histologic and immunohistochemical wound healing outcomes of MRS with conventional surgical techniques.
Main Methods:
- Superior rectus muscle resection was performed on 30 rabbits using three techniques: MRS, conventional scissors with bipolar electrocautery (BEC), and conventional scissors alone (control).
- Evaluated parameters included tissue injury, bleeding, inflammation, fibrosis, and wound healing rate (CD68+ cell count).
Main Results:
- MRS group showed significantly lower hemorrhage scores compared to conventional scissors (CS) and bipolar electrocautery (BEC) groups.
- BEC group exhibited higher tissue injury scores than the MRS group (p=0.028).
- Fibrosis scores were significantly higher in the control group compared to the MRS group (p<0.011).
Conclusions:
- Monopolar radiosurgery (MRS) is a viable alternative for strabismus surgery, demonstrating effective hemostasis and comparable wound healing.
- MRS enhances surgeon comfort through single-step muscle incisions and a cleaner surgical field, without compromising tissue healing.
