Botulinum toxin a treatment of consecutive esotropia in children
(Utilisation de la toxine botulique dans le traitement de l'ésotropie secondaire chez l'enfant)

Couser NL, Lambert SR.
Emory University Department of Ophthalmology , Atlanta , GA.

OBJECTIVE : To assess the outcome of botulinum A toxin (BTXA) to treat surgically overcorrected intermittent exotropia in children.

METHODS : A retrospective analysis was performed on a series of children with consecutive esotropia treated with BTXA.

RESULTS : Six children with a mean consecutive esotropia of 21 prism diopters (PD) were treated with BTXA at a mean of 19.8 months following strabismus surgery. Two patients underwent a single injection, three patients 2 injections, and one patient 3 injections. Complications included transient ptosis and a vertical deviation. Mean follow-up from last BTXA injection was 16 months. At last follow-up, 4 of the 6 patients were orthotropic and stereopsis was present in 4 of 5 patients old enough to cooperate with testing. One patient was treated with strabismus surgery following a single BTXA injection.

CONCLUSIONS :  BTXA is an efficacious treatment for consecutive esotropia in children. However, in our series, two-thirds of patients required multiple injections to achieve the desired outcome and one ultimately had an additional strabismus surgery.

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