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Botulinum toxin A injections may be effective treatment for medial rectus contraction
J Pediatr Ophthalmol Strabismus. 2011;48(3):187-191.
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For patients with medial rectus contraction in acute sixth nerve palsies, botulinum toxin A injections may be an effective treatment, a study suggested.
Fifteen of 34 patients with acute sixth nerve palsy and paresis received botulinum toxin A injections in the ipsilateral medial rectus muscle at doses ranging from 2.5 to 5 units, depending on deviation and abduction deficiency. Patients with chronic sixth nerve palsy underwent surgery, either ipsilateral medial rectus recession or recession combined with lateral rectus resection without transposition.
In the botulinum toxin A group, 13 of 15 patients (86.6%) recovered without any residual deviation; the other two patients sustained 6ΔD and 8ΔD of residual deviation. In the surgical group, mean preoperative deviation was 35.1ΔD and mean postoperative deviation was 2.57ΔD.
In the selected cases, “Early [botulinum toxin A] injection not only eliminates symptoms and improves the patient’s quality of life, but also reduces contracture of the ipsilateral medial rectus muscle, therefore allowing for complete recovery of lateral rectus muscle function,” the study authors said.