PURPOSE: To evaluate the long-term results of medial rectus recessions augmented by botulinum toxin injection for treating infants with large-angle (> 60 prism diopters [PD]) infantile esotropia. DESIGN: Interventional case series. SETTINGS: Hospital-based clinical practice. PATIENT POPULATION: Twenty-three patients with large-angle infantile esotropia who were followed for at least 2 years postoperatively. INTERVENTION: Surgical treatment with botulinum toxin in addition to bilateral medial rectus muscle recessions. The preoperative findings, treatment, and outcomes were reviewed. MAIN OUTCOME MEASURES: Surgery was considered successful if the patients did not require additional horizontal strabismus surgery and had less than 10 PD of horizontal deviation. RESULTS: The age at surgery ranged from 4 to 36 months (mean 14.5 months) and the angle of esotropia ranged from 65 to 100 PD (mean 72 PD). Treatment was successful in 17 of 23 patients (74%), with follow-up of 2 to 13 years (mean 6.6 years). CONCLUSION: Botulinum toxin-augmented medial rectus recession is an effective treatment for large-angle infantile esotropia, with stable results over time. Copyright Â
PURPOSE: To evaluate the long-term results of medial rectus recessions augmented by botulinum toxin injection for treating infants with large-angle (> 60 prism diopters [PD]) infantile esotropia. DESIGN: Interventional case series. SETTINGS: Hospital-based clinical practice. PATIENT POPULATION: Twenty-three patients with large-angle infantile esotropia who were followed for at least 2 years postoperatively. INTERVENTION: Surgical treatment with botulinum toxin in addition to bilateral medial rectus muscle recessions. The preoperative findings, treatment, and outcomes were reviewed. MAIN OUTCOME MEASURES: Surgery was considered successful if the patients did not require additional horizontal strabismus surgery and had less than 10 PD of horizontal deviation. RESULTS: The age at surgery ranged from 4 to 36 months (mean 14.5 months) and the angle of esotropia ranged from 65 to 100 PD (mean 72 PD). Treatment was successful in 17 of 23 patients (74%), with follow-up of 2 to 13 years (mean 6.6 years). CONCLUSION: Botulinum toxin-augmented medial rectus recession is an effective treatment for large-angle infantile esotropia, with stable results over time. Copyright Â
Authors: Christopher T Leffler; Kamyar Vaziri; Stephen G Schwartz; Kara M Cavuoto; Craig A McKeown; Krishna S Kishor; Adam C Janot Journal: Am J Ophthalmol Date: 2015-11-05 Impact factor: 5.258