In a series of 26 patients (11 female, 15 male) with large angle esotropia >35PD, the authors compared results of botulinum toxin A (BTA) and bridge Faden operation combined with bilateral medial rectus (BMR) recession. Overall age of surgery was 68.7 ±14.6 years. Group 1 comprised BMR with bridge Faden and group 2 comprised BMR with BTA. Preoperatively there was no significant difference between groups for mean deviation: group 1, 49.8 ±8.4PD and group 2, 49.3 ±11.2PD. At 12 months postoperative follow-up, mean deviation and complete success rates were 7.5 ±9.5PD and 63.6% for group 1, and 7.7 ±6.4PD and 66.7% for group 2. They acknowledge the limited sample size and lack of binocular vision and accommodation data. Conclusions are that both procedures give good results and provide an alternative to multiple muscle surgery.
Results of bilateral medial rectus recession combined with either BT or bridge Faden when treating large angle strabismus
Reviewed by Fiona Rowe
Comparison of botulinum toxin A injection and bridge Faden operation performed with bimedial rectus recession in patients with large-angle esotropia.
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Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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