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Comparison of Three Clinical Stereoscopic Methods for Measuring Binocular Visual Function During Amblyopic Treatment in Unilateral Amblyopia
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Treatment of Infantile Esotropia - Comparison Between Botulinum Toxin A and Bilateral Medial Rectus Recession

Cagri Mutaf1, Bulut Ocak2, Asli Inal3

  • 1Department of Ophthalmology, Harran University Faculty of Medicine, Sanlıurfa, Turkiye.

Beyoglu Eye Journal
|March 20, 2024
PubMed

Insights

Surgical recession is more effective for large infantile esotropia deviations (>30 PD). Botulinum toxin A (BTA) is a viable alternative for smaller deviations (<30 PD).

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus Surgery

Background:

  • Infantile esotropia (IE) is a common form of strabismus in children.
  • Treatment options include surgical correction and non-surgical methods like botulinum toxin A injections.
  • Comparing the efficacy of different treatment modalities is crucial for optimal patient outcomes.

Purpose of the Study:

  • To evaluate treatment outcomes for infantile esotropia.
  • To compare the effectiveness of botulinum toxin A (BTA) injections versus bilateral medial rectus (MR) recession surgery in children with IE.

Main Methods:

  • Retrospective review of medical records for 246 children diagnosed with IE.
  • Patients were categorized based on age and angle of deviation for treatment selection.
  • Comparison of success rates between BTA injection group (n=110) and bilateral MR recession group (n=124).
  • Successful correction defined as orthotropia or deviation ≤10 PD post-treatment.

Main Results:

  • Mean follow-up was 24.3 months (BTA) and 21.7 months (surgery).
  • Surgical group showed a higher success rate (72%) for deviations >30 PD compared to BTA (36%).
  • No significant difference in success rates for deviations <30 PD (surgery 62% vs. BTA 55%).

Conclusions:

  • Bilateral MR recession surgery is more successful for large-angle infantile esotropia (>30 PD).
  • Botulinum toxin A injection is a suitable alternative for smaller deviations (<30 PD).
  • Treatment choice should be tailored to the individual patient's deviation angle.
Abstract

Keywords:
Amblyopiabotulinum toxininfantile esotropiastrabismus

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