Botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of infantile esotropia: a pilot study

J, Chen; Deng, Daming; Zhong, Hua; Lin, Xiaoming; Kang, Yani; He-ping, WU; Yan, Jianhua; Mai, Guoqin

doi:10.1038/eye.2012.264

Cited by 27 publications

(34 citation statements)

References 13 publications

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“…8,12,15,16 Others opted for no EMG assistance. 11,13,17,18 Campos et al 14 performed the injections under direct visualization of the muscle. …”

Section: Discussionmentioning

confidence: 99%

“…Chen et al 17 compared the results of BT combined or not with sodium hyaluronate. We only included in the analysis the group in which BT was injected alone.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…8,[13][14][15][16][17][18] Also, many studies show that multiple injections may be needed to sustain the alignment effect. 19 On the other hand, the advantage is that BT is a simple treatment, in which injections are performed under minimal anesthesia without intubation.…”

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confidence: 99%

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The Use of Botulinum Toxin to Treat Infantile Esotropia: A Systematic Review With Meta-Analysis

Issaho

Carvalho

Tabuse

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Issaho DC, Carvalho FRS, Tabuse MKU, Carrijo-Carvalho LC, de Freitas D. The use of botulinum toxin to treat infantile esotropia: a systematic review with meta-analysis. Invest Ophthalmol Vis Sci. 2017;58:5468-5476. DOI:10.1167/iovs.17-22576 PURPOSE. The purpose of this review was to examine the efficacy of botulinum toxin in the treatment of infantile esotropia and to evaluate the average response of BT and its complication rates. METHODS. A research was performed in the Latin American and Caribbean Literature on Health Sciences (LILACS), MEDLINE, and Cochrane Central Register of Controlled Trial (CENTRAL).The database was searched between December 28, 2016 and January 30, 2017. The selection was restricted to articles published in English, Spanish, or Portuguese. There were no date restrictions in the search.RESULTS. Nine studies were eligible for inclusion. The grouped success rate of BT treatment in infantile esotropia was 76% (95% confidence interval [CI]: 61%-89%). For the success rate, I 2 of 94.25% was observed, indicating a high heterogeneity (P < 0.001). The complication rates were also analyzed. The grouped consecutive exotropia (XT) rate was 1% (95% CI: 0%-2%). The grouped ptosis rate was 27% (95% CI: 21%-33%). The grouped vertical deviation rate was 12% (95% CI: 4%-22%). The mean change of the deviation after BT injection was À30.7 (95% CI: À37.7, À23.8), demonstrating a significant improvement in alignment.CONCLUSIONS. Botulinum toxin injection into medial recti muscles reveals to be a safe procedure and a valuable alternative to strabismus surgery in congenital esotropia, especially in moderate deviations.

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“…8,12,15,16 Others opted for no EMG assistance. 11,13,17,18 Campos et al 14 performed the injections under direct visualization of the muscle. …”

Section: Discussionmentioning

confidence: 99%

“…Chen et al 17 compared the results of BT combined or not with sodium hyaluronate. We only included in the analysis the group in which BT was injected alone.…”

Section: Description Of Studiesmentioning

confidence: 99%

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The Use of Botulinum Toxin to Treat Infantile Esotropia: A Systematic Review With Meta-Analysis

Issaho

Carvalho

Tabuse

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…One such novel technique has been used in our study of combining sodium hyaluronate (SH) with BoNT-A injection in patients with IE, which by its physical property decreases the diffusion of the toxin to the neighboring tissues thereby decreasing the complication rate. [ 9 ] This technique was first described in a Chinese study in 2013. [ 9 ] Ours is the first study to be conducted on the Indian population.…”

mentioning

confidence: 99%

“…[ 9 ] This technique was first described in a Chinese study in 2013. [ 9 ] Ours is the first study to be conducted on the Indian population.…”

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confidence: 99%

Short-term outcome of botulinum neurotoxin A injection with or without sodium hyaluronate in the treatment of infantile esotropia—a prospective interventional study

Pandey

Agrawal

Srivastava

et al. 2020

Indian J Ophthalmol

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Purpose: To compare the short-term outcome of botulinum neurotoxin A (BoNT-A) with or without sodium hyaluronate in the treatment of infantile esotropia (IE). Methods: In this tertiary care hospital-based prospective, interventional, non-randomized study on infants with IE below one year of age, 25 cases were enrolled in the sodium hyaluronate (SH) group to receive 2.5 U BoNT-A injection combined with SH in each medial rectus muscle (MR). Thirty patients were enrolled in the control group to receive 2.5 U BoNT-A injection with normal saline in each MR. The change in mean primary ocular deviation (POD) and complications were assessed at 2 weeks, 1 month, 3 months, and 6 months post injection. Mann–Whitney U test was used for non-parametric unpaired data. Chi-square test and Fisher's exact test were used to test for the strength of the association between the two categorical variables. Results: Satisfactory ocular alignment was achieved in 76% in SH group and 73% in the control group ( P value = 0.80). While the change in mean POD was comparable (29.2 prism diopters [PD] vs 29.3 PD; P value = 0.65), the complication rates were significantly lesser in SH (16% vs 33.3%; P value = 0.14). Conclusion: BoNT-A combined with SH is equally effective with lesser complications as compared to botulinum toxin alone in the treatment of IE.

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Botulinum toxin for the treatment of strabismus

Rowe

Noonan

2017

Cochrane Database of Systematic Reviews

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Most published literature on the use of botulinum toxin in the treatment of strabismus consists of retrospective studies, cohort studies or case reviews. Although these provide useful descriptive information, clarification is required as to the effective use of botulinum toxin as an independent treatment modality. Six RCTs on the therapeutic use of botulinum toxin in strabismus, graded as low and very low-certainty evidence, have shown varying responses. These include a lack of evidence for effect of botulinum toxin on reducing visual symptoms in acute sixth nerve palsy, poor response in people with horizontal strabismus without binocular vision, similar or slightly reduced achievement of successful ocular alignment in children with esotropia and potential increased achievement of successful ocular alignment where surgery and botulinum toxin are combined. Further high quality trials using robust methodologies are required to compare the clinical and cost effectiveness of various forms of botulinum toxin (e.g. Dysport, Xeomin, etc), to compare botulinum toxin with and without adjuvant solutions and to compare botulinum toxin to alternative surgical interventions in strabismus cases with and without potential for binocular vision.

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Botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of infantile esotropia: a pilot study

Cited by 27 publications

References 13 publications

The Use of Botulinum Toxin to Treat Infantile Esotropia: A Systematic Review With Meta-Analysis

The Use of Botulinum Toxin to Treat Infantile Esotropia: A Systematic Review With Meta-Analysis

Short-term outcome of botulinum neurotoxin A injection with or without sodium hyaluronate in the treatment of infantile esotropia—a prospective interventional study

Botulinum toxin for the treatment of strabismus

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