Влияние величины угла косоглазия, возраста пациентов, дозировки препарата на эффективность лечения содружественного косоглазия у детей методом хемоденервации ботулиническим токсином типа А

Abstract

Purpose. To evaluate strabismus angle, patient's age, drug dosage on its treatment effectiveness in children using method of chemodenervation with botulinum toxin type A. Material and methods. The study involved 50 children (100 eyes), the average age of which was 4.33±2.75 years (from one year of life to 12.8 years), of which 27 boys (54%) and 23 girls (46%). The studies were carried out from 2016 to 2020 based on Voyno-Yasenetsky Scientific and Practical Center of Specialized Care or Children and Pirogov Russian National Research Medical University, Moscow. The observation period was 6 months. All patients were treated for concomitant strabismus by injecting BT-A into the oculomotor muscles through transconjunctival route, using specially designed forceps to isolate the oculomotor muscles, a syringe and a G27 needle (0.4×12.5 mm). Results. The success rate of the treatment of strabismus by chemodenervation using BT-A was 99.14% 6 months after the onset of treatment and was higher in children with a smaller angle of strabismus. The dosage of BT-A from 2 to 4 units gave the maximum effect when the angle of strabismus was more than 15°. Most of patients in the study group (75.49%) responded to therapy from the first month after chemodenervation. An analysis of data comparing the effectiveness of treatment in different age groups showed that the age of patients did not have a significant effect on the outcome of treatment – the outcome of treatment was more dependent on the initial angle of strabismus. Conclusion. Treatment of concomitant strabismus in children by chemodenervation of the extraocular oculomotor muscles with botulinum toxin type A can effectively eliminate the visible angle of concomitant strabismus and is an alternative to traditional surgical methods for treating children with this type of pathology. Key words: concomitant strabismus; botulinum toxin type A; chemodenervation, treatment efficacy