Botulinum toxin injection without electromyographic guidance in consecutive esotropia

Area of Science:

• Ophthalmology
• Strabismus Treatment
• Neuromodulation Therapy

Background:

• Consecutive esotropia can impair visual function and quality of life.
• Traditional treatments may have limitations or require complex procedures.

Purpose of the Study:

• To evaluate the effectiveness and safety of botulinum toxin injections for consecutive esotropia.
• To determine if electromyographic guidance is necessary for this treatment.

Main Methods:

• Retrospective analysis of 49 patients with consecutive esotropia treated with botulinum toxin.
• Injections administered to medial rectus muscles without electromyographic guidance.
• Success defined as orthotropic alignment or esodeviation ≤10 prism diopters (PD) at distance.

Main Results:

• Significant reduction in esodeviation at 6 months post-injection (mean 7.3 PD distance, 7.5 PD near, p<0.001).
• 69.4% of patients achieved successful alignment.
• Initial postoperative esodeviation ≤18 PD at one month predicted successful treatment (P = 0.007).
• Minor, transient side effects (ptosis, vertical deviation) in 8.2% of patients.

Conclusions:

• Botulinum toxin injection without electromyography is a safe and effective treatment for consecutive esotropia.
• Predictors of success include an initial postoperative esodeviation of 18 PD or less.
• This method avoids recurrent exotropia and offers a viable therapeutic option.