Effect of botulinum toxin A chemodenervation in sensory strabismus.
OBJECTIVE
To study the effect of botulinum toxin type A chemodenervation in sensory strabismus.


METHODS
Twelve patients with sensory strabismus were treated with an injection of botulinum toxin type A (Botox; Allergan, Irvine, Calif). Botulinum toxin type A was diluted with 0.9% sodium chloride without preservative at a dose that ranged from 1.25-5 U. A Teflon-coated needle electrode was inserted into the medial rectus muscle in cases of esotropia and into the lateral rectus muscle in cases of exotropia. Four patients were treated with > or =2 injections of botulinum toxin type A. Changes in the angle of strabismus and related complications were followed for >6 months postinjection.


RESULTS
The mean deviation before injection was 33.8 prism diopters (delta) and the mean corrective effect on the deviation was 72.8% after injection in patients with sensory strabismus. The final deviation in 9 patients was <10 delta. Complications were hypertropia in 3 (25%) patients and conjunctival hemorrhage in 1 (8.3%) patient.


CONCLUSIONS
Botulinum toxin type A is likely to prevent muscle contracture and affect muscle and neuronal tissues. This study on the effects of sensory strabismus with botulinum toxin type A injection suggests it has the potential to replace surgery or be used as an adjuvant therapy.
Han
S H
SH
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Lew
H
H
Jeong
C W
CW
Lee
J B
JB
D000328:Adult; D019274:Botulinum Toxins, Type A; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009121:Muscle Denervation / Q000379:methods*; D009465:Neuromuscular Agents; D009801:Oculomotor Muscles / Q000294:innervation*; D013285:Strabismus / Q000628:therapy*; D013563:Sympathectomy, Chemical / Q000379:methods*; D016896:Treatment Outcome; D015348:Vision, Binocular
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A