Botulinum toxin as an adjunct to monocular recession-resection surgery for large-angle sensory strabismus.
OBJECTIVE
To evaluate the result of using intraoperative botulinum toxin A (BTA) as an adjunct to monocular recession-resection surgery in the management of large-angle sensory strabismus.


METHODS
The medical records of patients diagnosed with sensory strabismus with constant large-angle strabismus were reviewed retrospectively to identify those who underwent monocular recession-resection surgery combined with 5 units of BTA injection into the recessed muscle of the nonfixating eye. Surgical outcome was considered successful if the final deviation was within the range of 0Δ-10Δ.


RESULTS
A total of 13 patients (mean age, 31.04 ± 18.5 years) were included, 8 with exotropia and 5 with esotropia. The mean follow-up period was 52.77 ± 10.9 months. The mean preoperative deviation was 66Δ± 16Δin the esodeviation group and 56Δ± 5Δin the exodeviation group. The final postoperative mean deviation was 6Δ± 7Δin the esodeviation group and 6Δ± 8Δin the exodeviation group. There were 7 patients (87.5%) with final deviation of ≤10Δin the exodeviaton group and 4 (80%) in the esodeviation group.


CONCLUSIONS
Adjunctive usage of BTA with conventional surgery appears to enhance surgical outcomes by increasing the amount of expected correction. The combined use of BTA with monocular recession-resection rectus muscle surgery may be a good alternative in the treatment of large-angle sensory strabismus with the advantage of less risk of potential complications compared to supramaximal surgery or surgery in the "good" eye.
Department of Ophthalmology, Faculty of Medicine, Dr. Bezmialem Vakif University, Istanbul, Turkey. Electronic address: betultugcu@gmail.com.
Betül
B
Tuğcu
Department of Ophthalmology, Faculty of Medicine, Dr. Bezmialem Vakif University, Istanbul, Turkey.
Eda
E
Sönmezay
Department of Ophthalmology, Faculty of Medicine, Dr. Bezmialem Vakif University, Istanbul, Turkey.
Fadime
F
Nuhoğlu
Department of Ophthalmology, Faculty of Medicine, Dr. Bezmialem Vakif University, Istanbul, Turkey.
Hakan
H
Özdemir
Department of Ophthalmology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey.
Seyhan Bahar
SB
Özkan
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005133:Eye Movements / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D009801:Oculomotor Muscles / Q000187:drug effects / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A