अमूर्त

Botulinum toxin; indications, success rates and complications in the management of horizontal strabismus in Saudi Arabia.

Abdulaziz A Al Taisan, Fatemah T Al Shamlan, Abdulmohsen K Al Mulhim, Abdulaziz I Alsomali, Adi M Al Owaifeer

Introduction: This study aims to analyze the indications, effectiveness and side effects of Botulinum toxin in the management of different horizontal strabismus entities. Methods: A retrospective analysis of cases underwent botulinum toxin injection for strabismus in Dhahran Eye Hospital from November 2013 till September 2016 where no previous surgery or intervention have been performed or a previous facial or ocular trauma. Main success indicator was a remaining angle of less than 10 prism diopter. Results: A total of 74 cases were included. 52.7% males and 47.3% females. Age ranged from two months to forty-five years. The most prevalent diagnosis was partially accommodative esotropia (PAET). The mean angle of deviation was 37.3 prism diopters (PD) with a range of 10 to 90 PD. Overall success rate was 54% with PAET scoring the highest (70.6%). No clinical significance was found regarding age, angle of deviation or the presence of amblyopia. However, the absence of inferior oblique overaction was statistically significant on the success rate of infantile esotropia. No serious peri-operative complications were documented. Conclusion: Botulinum toxin represents a cost effective, safe, repeatable alternative to surgery in the management of different entities of horizontal strabismus. Success rate differs in different diagnoses with PAET scoring the highest. Presence of inferior oblique overaction leads to a significant lower rate of success.