Botulinum Toxin A Treatment of Consecutive Esotropia in Children

Abstract

Objective: To assess the outcome of botulinum A toxin (BTXA) to treat surgically overcorrected intermittent exotropia in children.

Methods: A retrospective analysis was performed on a series of children with consecutive esotropia treated with BTXA.

Results: Six children with a mean consecutive esotropia of 21 prism diopters (PD) were treated with BTXA at a mean of 19.8 months following strabismus surgery. Two patients underwent a single injection, three patients 2 injections, and one patient 3 injections. Complications included transient ptosis and a vertical deviation. Mean follow-up from last BTXA injection was 16 months. At last follow-up, 4 of the 6 patients were orthotropic and stereopsis was present in 4 of 5 patients old enough to cooperate with testing. One patient was treated with strabismus surgery following a single BTXA injection.

Conclusions: BTXA is an efficacious treatment for consecutive esotropia in children. However, in our series, two-thirds of patients required multiple injections to achieve the desired outcome and one ultimately had an additional strabismus surgery.

KEYWORDS::

• Intermittent exotropia
• Consecutive esotropia
• Botulinum toxin

ACKNOWLEDGMENTS

Supported in part by NIH Departmental Core Grant EY06360 and Research to Prevent Blindness, Inc., New York, New York.

Declaration of interest: The authors declare no conflict of interest.