Vertical Rectus Muscle Transposition and Botulinum Toxin (Oculinum) to Medial Rectus for Abducens Palsy

Rosenbaum, Arthur L.; Kushner, Burton J.; Kirschen, David

doi:10.1001/archopht.1989.01070010842025

Cited by 118 publications

(50 citation statements)

References 8 publications

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“…No evidence for a prophylactic effect of botulinum toxin was found. However, the usefulness of combined treatment in sixth nerve palsy with surgery and botulinum toxin has been demonstrated (Fitzsimons et al 1988;Rosenbaum et al 1989). A careful study of factors influencing success of botulinum toxin treatment and the dose-effect relation in esotropia and exotropia has recently been performed (Abbasoglu et al 1996).…”

supporting

confidence: 40%

Treatment of strabismus and nystagmus with botulinum toxin type A, An evaluation of effects and complications

Lennerstrand

Nordbø

Tian

et al. 1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: Injection of botulinum toxin type A into eye muscles leads to a temporary paralysis and the effects have been evaluated in strabismus or nystagmus. Method: A total of 112 patients with different types of concomitant and paralytic strabismus and acquired nystagmus were treated with botulinum toxin, according to well-established indications. Results: The lasting effects of the injections on strabismic angle were largest in esotropia, consecutive exotropia and abducens palsy, and amounted to, on an average, 12 prism diopters or 6 degrees. The larger the strabismus the better was the effect. Repeated injections reduced the angle further. In complex nystagmus forms retrobulbar injections could be used. The side effects were mostly due to spread of botulinum toxin to the levator, producing ptosis (8%), or the inferior rectus muscle, causing vertical strabismus (10%). On an average 42% of the patients were later operated for strabismus and nystagmus. Conclusion: Injection of botulinum toxin A into eye muscles is a valuable adjunct to surgery in the treatment of strabismus and nystagmus.

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supporting

confidence: 40%

Treatment of strabismus and nystagmus with botulinum toxin type A, An evaluation of effects and complications

Lennerstrand

Nordbø

Tian

et al. 1998

Acta Ophthalmologica Scandinavica

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“…Simultaneous operation on MR has the risk of anterior segment ischemia. 3 To avoid this complication, some authors advocated botulinum toxin (BTX) injection to the MR. [4][5][6][7] The use of intraoperative BTX to weaken the antagonist MR in transposition procedures has been proposed by Scott. 8 Scott and Kraft postulated that BTX reduces contracture of the MR and allows for more complete recovery of LR muscle function.…”

Section: Introductionmentioning

confidence: 42%

Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Nabie

Andalib

2016

Eye

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Purpose To evaluate the results of augmented vertical rectus muscle transposition (VRT) with intraoperative botulinum toxin (BTX) for complete and chronic sixth nerve palsy. Methods During a 10-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) all patients with chronic and complete sixth nerve palsy and contracted medial rectus (MR) who underwent augmented VRT and BTX injection into the MR enrolled in this study. Results In total, 29 patients (5 bilateral) were enrolled in this study. Preoperative deviation was 45 ± 17.5 Prism Diopter (PD), which was improved to − 3.1 ± 13.2 after the operation (Po0.001). Mean preoperative and postoperative abduction limitation was − 4.4 ± 1.1 and − 1.8 ± 0.9, respectively (Po0.001). The success rate was 76% (deviation within 10 PD of orthotropia). Four patients (13.7%) had hypotropia. In 19 patients with preoperative deviation ≤ 45 PD, four patients had consecutive exotropia. Conclusion Intraoperative BTX injection with augmented vertical rectus transposition is an effective procedure. In deviation ≤ 45 there is a risk of overcorrection.

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“…However, a larger field of BSV averaging 41°can be achieved with the Jensen procedure,83 while T. MURRAY total transposition of the superior and inferior rectus to the lateral rectus combined with botulinum toxin injection of the medial rectus produces the largest field of between 51 ° and 78°.84.85 Six of 22 patients (27%) developed a vertical deviation with this procedure,86 which although more dif ficult to perform has gained popularity as the preferred surgical method for 'total' unrecovered sixth nerve pals y. [84][85][86] Even long -standing contracture of the medial rectus can be relieved with botulinum toxin, thus avoiding surgery to that muscle when simultaneous superior and inferior rec tus transposition is required and thereby reducing the risk of anterior segment ischaemia. Supermaximal surgery is of value when botulinum toxin is not available.…”

Section: Sixth Nerve Palsysupporting

confidence: 41%

Guest lecture strabismus: Challenges and trends

Murray

1993

Eye

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Vertical Rectus Muscle Transposition and Botulinum Toxin (Oculinum) to Medial Rectus for Abducens Palsy

Cited by 118 publications

References 8 publications

Treatment of strabismus and nystagmus with botulinum toxin type A, An evaluation of effects and complications

Treatment of strabismus and nystagmus with botulinum toxin type A, An evaluation of effects and complications

Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Guest lecture strabismus: Challenges and trends

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