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Mario Torres Garcia, Rodrigo Martinez, Mario Acosta Silva, Mario Najera Covarrubias, Katia Calderon Soto; Correction of accommodative factor in patients with residual esotropia after treatment with botulinum toxin for infantile esotropia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4715. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effect of the optical correction of accommodative factor in patients with residual esotropia after botulinum toxin treatment for infantile esotropia.
This is a descriptive, observational, cross-sectional and retrospective study; we included patients with infantile esotropia who have received a single dose of botulinum toxin in both medial rectus who have remained with residual esotropia. We subsequently treated them with full refractive correction for a period of three months, strabismus measurements were performed monthly. Optical treatment success was defined by the presence of ortho position or esotropia less than 10 prism diopters (PD) after three months of wearing glasses.
80 patients, average age: 0.76 ± 0.29 years old, 53% males and 47% females. Average angle of esotropia was 38 ± 8.4 PD previous to botulin toxin injection. Average of residual esotropia was 17.89 ± 9.08 PD. After three months with full optical correction the average esotropia was 11.8 ± 13.18 DP, 36 (45%) had ortho position, 40 (50%) had residual esotropia greater than 10 DP and 4 (5%) had consecutive exotropia (less than 10 DP). Mean spherical equivalent was +1.91 ± 1.1 DP with an average accommodative-convergence over acommodation ratio: 1.93 DP/1 ± 1.19 DP/1, the accommodative factor was 3.44 ± 2.73 DP.
The measurement and adequate treatment of accommodative factor is an important factor in achieving orthoposition in patients with infantile esotropia and should always be considered.
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