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Long-Term Effects of Botulinum Toxin in Large-Angle Infantile Esotropia

Flavio Gioele Gallo1, Carmen Plaitano2, Paolo Esposito Veneruso3

  • 1Department of Medicine and Surgery, University of Salerno, Salerno, Italy.

Clinical Ophthalmology (Auckland, N.Z.)
|October 29, 2020
PubMed

Insights

Early Botulinum toxin (BT) injections for large-angle infantile esotropia (IE) showed a low success rate. While BT reduced eye deviation, surgery was still needed for most patients.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus Surgery

Background:

  • Infantile esotropia (IE) is a common condition requiring timely intervention.
  • Large-angle IE poses significant challenges for motor outcome.
  • Early treatment aims to improve alignment and binocularity.

Purpose of the Study:

  • To analyze the motor outcomes of early Botulinum toxin (BT) treatment in infantile esotropia (IE).
  • To evaluate the efficacy of a single BT injection in managing large-angle IE.
  • To determine the long-term need for surgical intervention after BT treatment.

Main Methods:

  • Retrospective chart review of 130 infantile esotropia patients treated between 2004 and 2019.
  • Inclusion criteria focused on patients receiving BT injections before 13 months of age.
  • Analysis of motor outcomes and need for subsequent surgery in 30 eligible patients.

Main Results:

  • A single Botulinum toxin injection demonstrated a low success rate (6.7%) at final follow-up (mean 28.3 months).
  • Significant reduction in eye deviation was observed post-injection.
  • Twenty-eight patients (93.3%) with residual esotropia (≥25 PD) ultimately required surgical correction.

Conclusions:

  • Early Botulinum toxin injection for large-angle infantile esotropia has a limited success rate as a standalone treatment.
  • BT can temporarily reduce eye deviation but does not eliminate the need for surgical management.
  • Further research may explore optimal timing and combination therapies for infantile esotropia.
Abstract

Keywords:
congenitalpediatricstrabismus

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