ABSTRACT

To evaulate the efficacy of botulinum toxin A injection and factors affecting the treatment in strabismus.

Botulinum toxin A administered 43 patients with the diagnosis of horizontal deviation in Strabismus Department of Okmeydanı Training and Research Hospital Ophthalmology Clinic were analyzed retrospectively. A total of 55 injections were applied to the medial rectus with comitant and noncomitant esotropia or lateral rectus with comitant exotropia and were followed up for 3 months. A deviation of less than 5 prism diopters was considered successful, between 5-10 prism diopters as cosmetically successful and more than 10 prism diopters as unsuccessful.

A total of 43 patients (17 female, 26 male) with a mean age of 25.1 (8.54SD) years were included in this study. Of the 43 patients, 26 (60.5%) with esotropia and 17 (39.5%) with exotropia were presented. There were residual strabismus in 16 (37.2%) patients, paralytic strabismus in 19 (44.2%) patients and consecutive strabismus in 8 (18.6%) patients. The angle of deviation was 10-20 prism diopters in 30 (69.8%) patients and up to 20 prism diopters in 13 (30.2%) patients before botulinum toxin A administration. Success rate of patients who had deviation between 10-20 prism diopters was 83.3% and patients who had deviation up to 20 prism diopters was 46.2%. There was a statistically significant difference between angle of deviation (p<0.05). There was no statistical difference in the success rates between esotropia, exotropia and between paralytic strabismus, residual strabismus, consecutive strabismus (p>0.05).

Botulinum toxin A injection, which is effective in the treatment of strabismus, may be an alternative to surgery with minimal side effects especially in mild deviations of less than 20 prism diopters.