J Med Assoc Thai 2002; 85 (11):1189

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Botulinum A Toxin Therapy on Esotropia in Children
Tengtrisorn S Mail, Treyapun N , Tantisarasart T

A prospective descriptive study was conducted to determine the results of Botulinum Toxin
Type A (BT A) injection on esotropia in children, as this may be an alternative to incisional surgery
for strabismus. Between September 1998 and February 2002, eleven patients (6 boys and 5 girls)
with esotropia were treated with BTA at the Department of Ophthalmology, Songklanagarin Hospital.
The average ages at the time of the first and second treatments were 26.8 months (range 14-40 months)
and 32.3 months (range 19-54 months), respectively. An open sky procedure was used to inject the
BTA. Alignment withinเธ‘ 10 prism of orthotropia was considered a successful outcome of BTA treat-
ment in the patients.
If
the result of the first injection was an incomplete paralysis and the strabismus
remained undercorrected, the subsequent dose was increased up to double the initial dose. The mean
deviation angle was 40.4 prism diopter (PD) before the first injection and 24.5PD before the second
injection. Eight of 11 (72.7%) cases had a sucessful outcome. BTA injection in childhood esotropia
may be an alternative to incisional strabismus surgery.
Key word : Esotropia, Botulinum A Toxin, Children

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