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       XXVI Annual Congress of the Iranian Society of Ophthalmology        بـیــست و ششمین کنــگــره سـالیـانه انـجـمـن چـشـم پـزشـکی ایـــران
مقاله Abstract


Title: Evaluation of botulinum toxin injection in the treatment of recurrent or residual horizontal strabismus
Author(s): Reza Hosseini, MD; Mostafa Soltan Sanjari, MD; Seyed-Mahmood Motallebi, MD; Kaveh Abri Aghdam, MD; Reza Asadi, MD
Presentation Type: Oral
Subject: Strabismus & Neuro-ophthalmology
Others:
Presenting Author:
Name: Reza Hosseini
Affiliation :(optional) Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences
E mail: reza.hosseini@yahoo.com
Phone: 02188382476
Mobile: 09363454787
Purpose:

To evaluate the effect and success rate of unilateral or bilateral botulinum toxin injection in the treatment of recurrent or residual horizontal strabismus.

Methods:

A retrospective, single-center medical record review was performed in patients with post-surgical recurrent or residual horizontal strabismus treated with 10 units of Dysport® injection for each horizontal extraocular muscle during the 9 years from 2007 to 2015. Reaching to within 10 prism diopters (PD) of orthotropia for the angle of ocular deviation at distance after 1 to 4 injections was considered as successful motor outcome.

Results:

Thirty-five out of sixty-six patients, were esotropic and 31 cases were exotropic. The mean age of patients was 18.39 (SD = 13.12) years. At 1-week, 1-month, and 3-month post-injection visit and last visit (with a mean of 10.64 months), the successful motor outcome was achieved in 54.5%, 60.6%, 51.5%, and 45.5% of patients respectively, with statistically significant differences in the angle of deviation compared to pre-injection deviation (p < 0.001 for all of them), and the mean percentage net change in ocular deviations were 89.57%, 93.40%, 73.53%, and 56.21%, respectively. Patients with less than or equal to 20 PD pre-injection deviation, had a significantly higher success rate compared to those with >20 PD pre-injection deviation at 3-month post-injection visit (p = 0.007) and it was very close to significance at last visit (p = 0.053). The success rate was higher among patients treated within 1 month of previous surgery however it was not statistically significant. Ptosis and vertical eye deviation occurred in 10.6% and 6.1% of cases respectively.

Conclusion:

Botulinum toxin injection could be an effective alternative for reoperation, especially in small-angle deviations, for the treatment of recurrent or residual horizontal strabismus.

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