Abstract
The aim of this study is to assess the effectiveness of intraoperative botulinum toxin A (BTA) injection as an adjunct to the surgical treatment of large-angle esotropia or exotropia. Ten patients were included in the study. Mean age of the patients was 27+/-20 years. Of these 10 patients, 7 were esotropic and 3 exotropic. The average preoperative esodeviation was 73.6+/-16.5 prism diopters and exodeviation was 76.7+/-5.8 PD. Five units of BTA were injected intraoperatively into one of the recessed horizontal rectus muscles in all of the patients. The average follow-up was 14+/-10 months (range, 8 to 40 months). The average final deviation in the esotropia group was 13+/-9.6 PD of esotropia. The average final deviation in the exotropia group was 4.7+/-5 PD of exotropia. The final deviation of the 70% patients was within 10 PD of esotropia or exotropia. The results of this study suggest that the combination of BTA injection with recession may increase the expected correction of a conventional horizontal rectus muscle surgery.
Highlights
To summarize our fifteen-years clinical experience of using Botox in strabismology and determine the indications for the most effective use of chemodenervation in the complex treatment of oculomotor system pathology
Injection of Botox into the extraocular muscles in all cases was the primary method of treatment
The best results were obtained in treatment of decompensated heterophories, acute heterotrophies, atypical heterotrophies and primary hyperfunction of the inferior oblique muscles
Summary
To summarize our fifteen-years clinical experience of using Botox in strabismology and determine the indications for the most effective use of chemodenervation in the complex treatment of oculomotor system pathology. The best results were obtained in treatment of decompensated heterophories, acute heterotrophies, atypical heterotrophies and primary hyperfunction of the inferior oblique muscles (in 100% of cases) In these conditions, the binocular vision was preserved in patients, and the imbalance of the oculomotor system did not show any sign of incomitance. Chemodenervation of extraocular muscles is an effective independent and additional method of complex treatment of oculomotor system pathology and expands opportunities in patients’ rehabilitation. To achieve maximum functional results, it is necessary to select patients correctly for this procedure, taking into account its appropriateness and advantages over alternative methods of treatment, selection of optimal dosages of Botox. Цель данной работы — подвести итог пятнадцатилетнего клинического опыта применения ботокса в страбизмологии и определить показания для наиболее эффективного применения хемоденервации в комплексном лечении патологии глазодвигательной системы
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