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[Results with botulinum toxin in patients with esotropia and psychomotor deficit]
María Estela Arroyo-Yllanes1, José Fernando Pérez-Pérez, Leopoldo Murillo-Murillo
1Clínica de Oftalmología Pediátrica y Estrabismo, Hospital General de México OD, México, D.F., Mexico. mearroyo1@gmail.com
Objective:
We undertook this study to evaluate the results of the treatment with botulinum toxin in patients with esotropia and psychomotor delay.
Methods:
Patients with esotropia and delayed psychomotor development, in rehabilitation therapy and without previous surgery were included. A complete ophthalmological and strabismological exploration was performed including cycloplegic refraction with atropine 1%. Botulinum toxin was applied under sedation in both internal recti. Results were evaluated 1 week, 1 month, 3 and 6 months and after 1 year of application. The reinjection was decided if a 25 DP esotropia or greater was obtained before 3 months of the first application. A good result was considered in patients who had 10 DP of deviation and variability <10 DP.
Results:
Thirty two patients were included. There were 14 were women and 18 men with an age range from 5 months to 5 years (average 16.8 months). Eighteen patients had variability in the angle of deviation from 20 to 45 DP of esotropia and 14 without variability with an average of 39.12 DP. Thirteen patients were reinjected. A good result was obtained in 10 patients, fair in 17 patients and poor in 5 patients due to persistence of variability in four cases and 15 DP hypertropia in one.
Conclusions:
Application of botulinum toxin is a therapeutic alternative in patients with esotropia and psychomotor delay.
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