Abstract
Purpose :
Objectively evaluate the efficacy of BTA in the treatment of abducens nerve palsy/paresis in 10 patients, analyzing ectoscopy, decrease in diplopia and patient's satisfaction.
Methods :
The method consists of applying BTA to the medial rectus muscle, 10 mm away from the limbus, measured with a surgical compass, without opening the conjunctiva, with an insulin syringe and needle.
In eyes with palsy 7 units were applied and in eyes with paresis 5 units were applied.
The medication used was Botox (Allergan,100 U bottle diluted in 2 ml of 0.9% saline solution).
Thirty days after application, results were objectively evaluated and patients were asked about their satisfaction.
Results :
Seven had lateral rerctus muscle paresis and three had palsy.
The age of patients ranged from 35 to 70 years (mean 55 years) and 60% were male.
Three patients were diabetic and hypertensive, two were only hypertensive, two had hypercholesterolemia and three had no comorbidities.
At the time of treatment, 4 patients reported having the diagnosis for more than a year, 6 patients sought care within the first 15 days of the disease and were treated with BTA one month after the onset of the condition.
Seven patients had objective improvement of diplopia, five of which had paresis and two had palsy of the medial rectum. After a year of follow-up, only one patient among the seven required a new application of BTA, 6 months after the first, obtaining again a good result. The others continued without diplopia.
Among the 4 patients who performed the BTA application after 1 year of diagnosis, 2 (50%) had improved diplopia and 2 had not. Only 1 patient (25%) was satisfied with the result.
Among the 6 patients with less than three months of evolution, five (83.4%) were satisfied and showed improvement in diplopia and one was dissatisfied (16.6%) and did not show improvement in diplopia.
As for satisfaction with the procedure, the 6 patients who presented paresis said they were satisfied and 4 said they were dissatisfied (one with paresis and three with palsy).
Conclusions :
Our results show that the application of TBA was more effective in cases of paresis with 15 days to three months of evolution.
Paresias had a much stronger improvement in diplopia and satisfaction with the treatment, compared to palsies.
The method of injecting BTA without a microscope use or opening the conjunctiva, was simple, safe and effective.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.