Effect of Botulinum Toxin A Chemodnervation in Sensory Strabismus
Lew ; Helen ; Sueng Han ; Han ; Jeong ; Chang Woog ; Lee ; Jong Bok
Journal of Pediatric Ophthalmology & Strabismus, Vol.38(2) : 68~71, 2001
Journal of Pediatric Ophthalmology & Strabismus
To study the effect of botulinum toxin type A chemodenervation in sensory strabismus.
Twelve patients with sensory strabismus were treated with an injection of botulinum toxin type A (Botox; Allergan, Irvine, Calif). Botulinum toxin type A was diluted with 0.9% sodium chloride without preservative at a dose that ranged from 1.25-5 U. A Teflon-coated needle electrode was inserted into the medial rectus muscle in cases of esotropia and into the lateral rectus muscle in cases of exotropia. Four patients were treated with > or =2 injections of botulinum toxin type A. Changes in the angle of strabismus and related complications were followed for >6 months postinjection.
The mean deviation before injection was 33.8 prism diopters (delta) and the mean corrective effect on the deviation was 72.8% after injection in patients with sensory strabismus. The final deviation in 9 patients was <10 delta. Complications were hypertropia in 3 (25%) patients and conjunctival hemorrhage in 1 (8.3%) patient.
Botulinum toxin type A is likely to prevent muscle contracture and affect muscle and neuronal tissues. This study on the effects of sensory strabismus with botulinum toxin type A injection suggests it has the potential to replace surgery or be used as an adjuvant therapy.