title: The use of botulinum toxin to treat strabismus following retinal detachment surgery.
abstract: METHODS
  Persistent symptomatic strabismus may be seen in up to 25% of patients post retinal detachment surgery. Surgical correction of ocular misalignment in this situation can be technically difficult to perform and the results are less predictable than in other forms of strabismus surgery. We report on our experience of the use of botulinum toxin injections as an alternative.
  
  
  RESULTS
  A retrospective review was made of all patients who had received botulinum toxin injections in the management of their strabismus following retinal detachment surgery at our institution between November 1982 and January 2006. One hundred and forty patients fulfilled our criteria with a mean length of follow-up of 27 months. Thirty-three patients (23.6%) were symptom free following botulinum toxin injection alone and were discharged from the clinic, 50.5% of these after only 2 injections. Fusion was regained in 37.9%. The only factor associated with lack of restoration of fusion in the multivariate analysis was visual acuity in the injected eye. Complications were seen in 2.9% of patients.
  
  
  CONCLUSIONS
  Botulinum toxin injections may represent a safe and acceptable alternative to surgery and may be particularly useful for those in whom surgery is contraindicated or not desired.
authors.affiliation: Moorfields Eye Hospital, London, EC1V 2PD United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Gardner
authors.forename: Emma L
authors.initials: EL
authors.lastname: Dawson
authors.forename: Gillian G
authors.initials: GG
authors.lastname: Adams
authors.forename: John P
authors.initials: JP
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage; D001905:Botulinum Toxins / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D013285:Strabismus / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins