Immediate and sustained resolution of chronic post-traumatic diplopia following lower eyelid adhesiolysis using plasma energy (Plexr): An 8-month follow-up case report.

A plasma adhesiolysis procedure is a minimally invasive technique that uses plasma energy generated by the Plexr device to separate fibrous adhesions between tissues. Although this technology has been used in periocular procedures, its application in treating chronic restrictive diplopia is largely undocumented. This case aimed to illustrate the potential alternative to surgery in patients with long-term, post-traumatic restricted diplopia via non-surgical intervention. A 35-year-old woman presented with chronic post-traumatic diplopia persisting for eleven years after a left orbital floor blow-out fracture. She had previously undergone two orbital reconstructions using porous polyethylene (Medpor) implants, performed in 2014 and 2019, without achieving functional improvement. In October 2025, she underwent a minimally invasive procedure involving plasma-assisted adhesiolysis of the lower eyelid using the plasma energy (Plexr) device. The intervention led to immediate improvement: ocular motility was restored intraoperatively, and the patient's diplopia resolved completely within approximately 5 min. Importantly, at long-term follow-up on May 12, 2026 (approximately eight months later), the patient remained completely free of diplopia in all gaze positions, with full ocular motility bilaterally and sustained aesthetic improvement of the left lower eyelid, including reduction of edema and tissue asymmetry. This case demonstrates the potential of non-surgical plasma adhesiolysis to achieve both immediate and durable restoration of ocular motility in chronic restrictive diplopia secondary to trauma and multiple orbital surgeries. The fast improvement seen in this case suggests that plasma-based adhesion release may serve as an alternative to traditional surgery for managing long-standing post-traumatic motility restrictions.