Botulinum Treatment of Childhood Strabismus

Long-term follow-up of bilateral botulinum toxin injections versus bilateral recessions of the medial rectus muscles for treatment of infantile esotropia

“…5,[8][9][10][11][12][13] The reported motor success rate of botulinum toxin treatment of infantile esotropia ranges from 33% to 89%. 3,4,5,[8][9][10] Surgical treatment has been the standard of care for infantile esotropia, reaching .80% success rates with short-and mid-term follow-up 11 ; however, the percentage of patients requiring further subsequent operations increases with longer follow-up times. 12,13 Louwagie BCVA, best-corrected visual acuity; D, diopters; PD, prism diopters.…”

Comparison of botulinum toxin with surgery as primary treatment for infantile esotropia

“…[1][2][3]9 A transient consecutive exotropia is the most desirable outcome after botulinum injection, 6,14 as the visual feedback may stimulate readjustment of fusion pathways. 6 Nonresolving exotropias occur in 1% to 5% of patients.…”

“…These findings are consistent with other reported successful outcomes in patients with infantile esotropia, 5 acquired childhood esotropia, 9 and mixed strabismus populations treated with botulinum toxin. 20 In studying the treatment of infantile esotropia, the rate of spontaneous resolution should also be considered. In the Congenital Esotropia Observation Study, spontaneous resolution (within 8 D of orthotropia) was observed between 28 and 32 weeks of age in 27% of patients with esotropia greater than 20 D .…”

“…Several articles [1][2][3][4][5][6][7] have been published on this topic reporting a wide range of succes rates, with 33% to 88% of patients achieving alignment within 10 D of orthotropia. These findings, however, are limited by study designs that lack randomization, have small sample sizes, short follow-up, or ill-defined (heterogeneous) patient populations.…”

“…These findings, however, are limited by study designs that lack randomization, have small sample sizes, short follow-up, or ill-defined (heterogeneous) patient populations. 1,3 Table 1 [1][2][3][5][6][7] summarizes the most important retrospective studies. Other studies 8,9 have published satisfactory results in the treatment of acquired childhood esotropia and consecutive or residual esotropia with botulinum toxin.…”