title: Botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of infantile esotropia: a pilot study.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of a revised technique of botulinum toxin type A (BTA) injections for the treatment of infantile esotropia.
  
  
  METHODS
  Forty-seven patients with infantile esotropia were randomly divided into two groups. In group A, 23 cases were treated with a bilateral injection of 2.5-3.75 U BTA combined with sodium hyaluronate (SH) to the medial rectus muscle. In group B, 24 cases were treated with a bilateral injection of 2.5-3.75 U BTA solution alone to the medial rectus muscle. Electromyography was not used in the study. All patients received one injection and were evaluated 2 weeks, 3 months, and 6 months following injection.
  
  
  RESULTS
  The measured changes between groups A and B included the frequencies of good alignment 6 months after injections (30.4% vs 37.5%), complicated ptosis (2.2% vs 20.8%), and vertical deviation (2.2% vs 2.1%).
  
  
  CONCLUSIONS
  BTA injections combined with or without SH in the absence of electromyography demonstrated effectiveness and feasibility in the treatment of infantile esotropia. A relative decrease in the frequency of complicated ptosis resulted from injections of BTA+SH.
authors.affiliation: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: D
authors.initials: D
authors.lastname: Deng
authors.forename: H
authors.initials: H
authors.lastname: Zhong
authors.forename: X
authors.initials: X
authors.lastname: Lin
authors.forename: Y
authors.initials: Y
authors.lastname: Kang
authors.forename: H
authors.initials: H
authors.lastname: Wu
authors.forename: J
authors.initials: J
authors.lastname: Yan
authors.forename: G
authors.initials: G
authors.lastname: Mai
mesh_terms: D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004576:Electromyography; D004948:Esotropia / Q000188:drug therapy* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D009465:Neuromuscular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009801:Oculomotor Muscles / Q000187:drug effects* / Q000503:physiopathology; D010865:Pilot Projects; D016896:Treatment Outcome; D055675:Viscosupplements / Q000009:adverse effects / Q000627:therapeutic use*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009465:Neuromuscular Agents; D055675:Viscosupplements; D006820:Hyaluronic Acid; D019274:Botulinum Toxins, Type A