In this study, the authors evaluate the efficacy of botulinum toxin A (BTA) as a treatment option for consecutive exotropia. This was a retrospective review of 34 patients; 23 female and 11 male. Age at BTA was a mean of 169 ±88.9 months and follow-up was for a range of 6–84 months (mean 19.8 ±20 months). Eight patients had infantile esotropia and 26 had acquired esotropia; 7 anisometropia, 20 amblyopic, 9 with fusion and 25 with no binocular vision. Pre-treatment angle was 20.03 ±8,42PD for near and 21.41 ±8.87PD for distance. Patients had, on average, 1.6 ±1.1 BTA injections. At 6 months post treatment, angle was 9.65 ±7.42PD for near and 10.82 ±7.33PD for distance. The near angle at 1 month was significantly associated with the 6-month and overall treatment success. Distance angle at 1 month was only moderately associated with the 6-month follow-up, and weak for overall. Presence of fusion had a weak association with 6-month and overall follow-up. Overall success was 73.5%. The authors conclude BTA is an effective alternative treatment option vs surgery for small angle consecutive esotropia.
BT as an effective alternative treatment for small angle consecutive exotropia
Reviewed by Fiona Rowe
Botulinum toxin A for management of consecutive exotropia: factors affecting treatment success.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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