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Botulinum toxin shows stable results in treating large-angle infantile esotropia
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Bilateral medial rectus muscle recession augmented by surgical treatment with botulinum toxin for large-angle infantile esotropia showed stable results over time, according to a study.
The interventional case series included 23 patients aged 4 to 36 months with large-angle infantile esotropia who received treatment with botulinum toxin in addition to bilateral medial rectus recession.
The mean angle of esotropia was 72 ∆D (range: 65 to 100 ∆D), and mean follow-up was 6.6 years (range: 2 to 13 years).
Surgical treatment succeeded in 17 of the 23 patients (74%). Surgical success was defined as requiring no additional horizontal strabismus surgery and less than 10 P∆ of horizontal deviation.
“The primary weakness of the current study is that it is retrospective, and botulinum augmentation was used in all patients with large-angle esotropia during the course of the study, so no direct comparison group is available,” the study authors said. “Until [a prospective, randomized] study is performed, our results indicate that augmentation of medial rectus muscle recessions with botulinum-toxin chemodenervation is a good option for the treatment of patients with large-angle infantile esotropia.”
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