Botulinum Toxin Injection versus Extraocular Muscle Surgery for Acute Acquired Comitant Esotropia

Figures & data

Table 1 Summary of Patients’ Baseline Characteristics

Patient Characteristics	Surgery	Botulinum Toxin	Total	P-value
Total	80	34	114
Sex n (%)				0.209
Female	36 (45)	11 (32.5)	47 (41.2)
Male	44 (55)	23 (67.6)	67 (58.8)
Age at treatment (Mean ± SD)	14.0 ± 13.4	13.5 ± 10.5	13.9 ±12.5	0.826
BCVA (logMAR) (Mean ± SD)	0.33 ± 0.53	0.02 ± 0.07	0.24 ± 0.47	<0.001
Refraction (S.E.) (Mean ± SD)	−0.2 ± 3.1	−0.3 ± 2.0	−0.2 ±2.8	0.926
Amblyopia n (%)				0.809
Yes	47 (58.8)	18 (56.2)	65 (58)
No	33 (41.2)	14 (43.8)	47 (42)

Table 2 Preoperative and Postoperative Angle of Deviation

Preoperative Deviation Angle (Mean ± SD)	N	Baseline	Postop 1 Mo	Postop 3 Mo	Postop 6 Mo	P-values
Small-angle (≤ 40 PD) subgroup	32					0.050
Surgery	25	30.0 ± 8.5	2.4 ± 4.5	2.2 ± 3.4	3.2 ± 8.4
Botulinum toxin	7	30.7 ± 11	6.0 ± 7.8	14.0 ± 13.4	17.1 ± 15.6
Large angle (>40 PD) subgroup	82					<0.001
Surgery	55	60.3 ± 12.7	6.0 ± 9.4	5.7 ± 11.1	6.5 ± 10.9
Botulinum toxin	27	56.5 ± 9.4	16.0 ± 18.7	24.0 ± 20.2	35.0 ± 24.3
All subgroups	114					<0.001
Surgery	80	50.8 ± 18.3	4.7 ± 8.3	4.6 ± 9.5	5.5 ± 10.3
Botulinum toxin	34	51.2 ± 14.3	13.9 ± 17.4	22.0 ± 19.3	31.3 ± 23.8

Abbreviation: PD, prism diopter.

Table 3 Success Rate of Surgery and Botulinum Toxin Injection

Treatment Outcomes	Postop 1 Mo			Postop 3 Mo			Postop 6 Mo
	Surgery n (%)	Botulinum Toxin n (%)	P-value	Surgery n (%)	Botulinum Toxin n (%)	P-value	Surgery n (%)	Botulinum Toxin n (%)	P-value
Small angle
Subgroup	25	7	0.046	25	7	0.137	25	7	<0.001
- Failure	2 (8)	3 (42.9)		1 (4)	5 (71.4)		5 (20)	5 (71.4)
- Success	23 (92)	4 (57.1)		24 (96)	2 (28.6)		20 (80)	2 (28.6)
Large angle
Subgroup	55	27	0.025	55	27	<0.001	55	27	<0.001
- Failure	13 (23.6)	14 (51.8)		12 (21.8)	20 (74.1)		12 (21.8)	20 (74.1)
- Success	42 (76.4)	13 (48.2)		43 (78.2)	7 (25.9)		43 (78.2)	7 (25.9)
All subgroups	80	34	0.005	80	34	<0.001	80	34	<0.001
- Failure	15 (18.7)	17 (50)		13 (16.2)	25 (73.5)		17 (21.2)	25 (73.5)
- Success	65 (81.3)	17 (50)		67 (83.8)	9 (26.5)		63 (78.8)	9 (26.5)

Figure 1 Improvement in the angle of deviation after treatment compared between the botulinum toxin and surgery groups.

Figure 2 Improvement in the angle of deviation after treatment (small-angle subgroup).

Figure 3 Improvement in the angle of deviation after treatment (large-angle subgroup).