title: To what extent may Botulinum toxin type A injections be an alternative choice to surgery in infantile esotropia?
abstract: BACKGROUND
  Evaluation of a single injection of botulinum toxin A in infantile esotropia as an alternative choice to surgery in a retrospective cases serie.
  
  
  METHODS
  Patients (65 consecutive children aged 9 to 26 months with infantile strabismus) underwent botulinum toxin A injection in both medial recti Botulinum toxin A injection. Clinical datas including measurement of angle of deviation before and after injection. visual acuity, stereoscopy and side effects were observed in a 24 months period of follow-up.
  
  
  RESULTS
  Stable satisfactory result (angle equal to or less than 8 dioptres) was obtained in 33 cases (50.7%). Excellent result (-2 to + 4 dioptres) were obtained in 17 children (26%). Additional surgery was required in 32 cases for a residual (albeit smaller angle than the initial deviation) or recurrent deviation and/or DVD (49,2%).
  
  
  CONCLUSIONS
  Botulinum toxin A reduces the tonic spastic motor component of strabismus and, should additional surgery be required (49% in our series), allows the procedure to be carried out on a smaller angle. A reduction in the maximum angle of deviation is thus achieved sooner, and allows the development of anomalous binocularity in a stable microtropia.
authors.affiliation: Department of Ophthalmology, Strasbourg University, Strasbourg - France.|Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University, Strasbourg - France.
authors.forename: Claude
authors.initials: C
authors.lastname: Speeg-Schatz
authors.affiliation: Department of Ophthalmology, Strasbourg University, Strasbourg - France.
authors.forename: Paul
authors.initials: P
authors.lastname: Burgun
authors.affiliation: Department of Ophthalmology, Strasbourg University, Strasbourg - France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Gottenkiene
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D004948:Esotropia / Q000628:therapy*; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A