The Effect of Botulinum Toxin Augmentation on Strabismus Surgery for Large-Angle Infantile Esotropia

American Journal of Ophthalmology
Michael J WanAnkoor S Shah

Abstract

To determine whether botulinum toxin augments the effect of strabismus surgery in pediatric patients with large-angle infantile esotropia. Retrospective, comparative, case series. Setting: Tertiary-care pediatric hospital. Patients with large-angle infantile esotropia. Treatment with botulinum toxin-augmented bilateral medial rectus muscle recessions ("augmented-surgery group") or traditional bilateral medial rectus muscle recessions ("surgery-only group"). The effect of surgery on ocular alignment at 4 months, measured in prism diopters of change per mm of surgery (PD/mm). There were 14 patients in the augmented-surgery group and 16 patients in the surgery-only group. The mean effect on alignment was significantly greater in the augmented-surgery group compared to the surgery-only group at 4 months (5.7 ± 1.3 vs 4.0 ± 1.4 PD/mm, P = .002) and at 1 year (5.4 ± 1.2 vs 3.7 ± 1.2 PD/mm, P = .002). There was a partial loss of treatment effect between 4 months and 1 year in both groups, which was similar in magnitude (P = .57). On linear regression, there was a trend toward a positive correlation between botulinum toxin dose and treatment effect, but this was not statistically significant (P = .09). Botulinum toxin augments the surg...Continue Reading

Citations

Feb 28, 2020·Clinical Ophthalmology·Viola Andin DohvomaCôme Ebana Mvogo
May 7, 2019·Journal of Binocular Vision and Ocular Motility·Rosario Gómez de Liaño
Jun 11, 2019·Seminars in Ophthalmology·Anna G Escuder, David G Hunter
Jan 8, 2021·BMC Ophthalmology·Minghua ShiHongxing Ren

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