Abstract
Purpose :
To observe the efficacy of BTA comparing to strabismus surgery in the treatment of children concomitant strabismus in the short term.
Methods :
Collected data were part of a prospective study testing the effects of BTA.Consecutive patients aged＜18 years with concomitant strabismus in surgical indication at the clinic were eligible for inclusion from April 1st to Aug. 31st in 2018.They were divided into two groups according to their parents, to choose BTA injection (group 1) and surgery (group 2).Cases with history of prior strabismus surgery, vertical strabismus, nystagmus, and underlying neurologic or developmental abnormalities were excluded, as patients did not return for follow-up.All parents gave informed consent.The distance(6m) and near(33cm) deviations in primary position were measured. Binocular visual function was examined by synoptophore and Random-dot stereogram.
Results :
Data from 62 children with concomitant strabismus were analyzed.There were 21 patients (7 females) in group 1 and 41 patients (20 females) in group 2.Mean age of group 1 was (9.57±2.69) years (4~13) years and (6.46±1.80) years (3~11) years in group 2. 20 patients (35 patients) with intermittent exotropia and 1(3) with partial accommodative esotropia were included in group 1 (in group 2).And there were 2 with alternate exotropia and 1 with concomitant esotropia in group 2.In group1, the preoperative deviation was (36.78±10.10)△(20~65)△ and (6.01±10.01)△(0~45)△ 3 months after BTA injection.In group 2, the preoperative deviation was (39.82±8.41)△(20~75)△ and (10.77±9.693)△(0~40)△ 3 months after surgery.There was no significant difference in the recovery rate(≤10△)between the groups (76.19% vs. 65.85%, P=0.403).In group 1, 10% patients ( vs. 41% in group 2) were found to have fusion rebuilt, and 14% patients ( vs. 24% in group 2) have distance stereopsis rebuilt; meanwhile 38% patients ( vs. 30% in group 2) were found to have near stereopsis improvement.
Conclusions :
Botulinum toxin is as effective as surgery in the treatment of children concomitant strabismus in the short term.Regarding eye position control, the effect of BTA injection is comparable to even better than surgery.Meanwhile, it has some improvement for binocular visual function after BTA injection.Due to insufficient sample size and follow-up time, the long-term efficacy is not able to be determined.Largescale and longer-term follow-up is required.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.