Botulinum A Toxin Therapy on Esotropia in Children

SUPAPORN TENGTRISORN, M.D.*, NUNTAPORN TREYAPUN, M.D.**, THAWA T TANTISARASART, M.D.*

Affiliation : * Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla 90112, **Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.

AbstractA prospective descriptive study was conducted to determine the results of Botulinum Toxin Type A (BTA ) injection on esotropia in children, as this may be an alternative to incisional surgery for strabismus. Between September 1998 and February 2002, eleven patients (6 boys and 5 girls) with esotropia were treated with BTA at the Department of Ophthalmology, Songklanagarin Hospital. The average ages at the time of the first and second treatments were 26.8 months (range 14-40 months) and 32.3 months (range 19-54 months), respectively. An open sky procedure was used to inject the BTA. Alignment within± 10 prism of orthotropia was considered a successful outcome of BTA treat ment in the patients. If the result of the first injection was an incomplete paralysis and the strabismus remained undercorrected, the subsequent dose was increased up to double the initial dose. The mean deviation angle was 40.4 prism diopter (PD) before the first injection and 24.5PD before the second injection. Eight of 11 (72.7%) cases had a sucessful outcome. BTA injection in childhood esotropia may be an alternative to incisional strabismus surgery.

Keywords : Esotropia, Botulinum A Toxin, Children

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