The authors conducted a systematic review and meta-analysis to evaluate the efficacy of botulinum toxin A (BTA) vs bilateral medial rectus muscle recessions for management of partially accommodative esotropia. They included 4 eligible studies with a total of 521 patients. Of these, 261 (50%) had BTA of 2.5–10 IU dose. Comparable motor success rates were found for BTA vs surgery. However, consecutive exotropia was reported in the surgery group only. The limitations of this review were that all included studies were observational and therefore with risk of bias due to potential confounding factors. There was significant heterogeneity in studies. Only 4 studies were included hence, the authors were unable to recommend one treatment over another. Further trials are needed and the authors recommend individualised management plans.
Systematic review of BTA vs surgery for partially accommodative esotropia
Reviewed by Fiona Rowe
Botulinum toxin A vs bilateral median rectus recession for partially accommodative esotropia: a systematic review and meta-analysis.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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