The effects of botulinum toxin injected in patients with acu
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The injection of botulinum toxin has a good effect on acute acquired concomitant esotropia in adults with minimal and moderate squinting and in children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery. In this prospective, nonrandomized, controlled clinical study, excessive near work was identified as an important risk factor for acute acquired concomitant esotropia in patients equal to or more than 14 years of age.

In this clinical study patients with acute acquired concomitant esotropia elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.

A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases equal to or more than 14 years of age and 9 cases less than 14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children, less than 14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence.

Source:https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-020-01787-1
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