The aim of the study was to evaluate the correction of esotropia and face turn due to Duane’s retraction syndrome (DRS) type I. The mean age was 21 months (12-36 months). The mean dose of botulinum toxin (BT) was 5.6±1.8IU (2.75 to 7.5) diluted in 0/9% saline solution. Mean follow-up was 74±71 months (18 months to seven years). Six patients had one injection and two patients had two injections. The mean preoperative esotropia was 32±10PD reducing to 9±12PD at final assessment. At final assessment, four patients had a deviation of 0-4PD, one had a 3PD exotropia with 5PD hypertropia, and three patients had a mean esotropia of 25PD requiring surgery. Complete limitation of abduction was noted in five patients. Face turns ranged from 15 to 45 degrees but improved in all cases. Ptosis occurred in three cases and one patient developed a vertical deviation post BT. The authors conclude that their patients achieved a good result and propose that BT should be considered as a treatment option in young patients with DRS in which surgery needs to be delayed or avoided.

Botulinum toxin in patients up to three years of age who have esotropic Duane’s retraction syndrome.
Maya JF, Gomez de Liana R, Catalan MRG, Reward O.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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