In this study, the success rate of treatment for infantile esotropia (IET) patients who had surgery because of under correction after botulinum toxin (BT) is compared to those having primary surgery. The study included 52 patients (27 male) with mean age of 23.1 ±15.1 months at presentation. Refraction, anisometropia, amblyopia, and angle of deviation were comparable between groups. Age at presentation for BT was 14 ±6.8 months which was significantly different to the surgery group (32.3 ±15.6 months). The BT group had a significant reduction in angle of deviation at six months post injection. Mean duration from injection to surgery was 20.6 ±15.1 months with a minimum six-month interval. Success rates were 76.9% for BT vs 88.5% surgery at near fixation and 80.8% vs 88.5% at distance fixation. These rates were significant greater for the surgery group. The authors discuss this retrospective study as reflecting their general clinical practice. Finding roughly comparable success rates they discuss the potential still to consider BT for early presentation of IET, particularly if keen to gain better alignment with potential for development of binocular vision, but resorting to surgery for later presentations.
BT vs primary surgery for infantile esotropia
Reviewed by Fiona Rowe
A comparative analysis of surgical outcomes for infantile esotropia with and without prior botulinum toxin A injection.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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