A Study of Non-surgical Treatment of Strabismus with Botulinum Toxin A(Oculinum(R))

Kim, Jae Chan; Kim, Kyu Seop; Koo, Bon Sool

Abstract

Forty eight cases of strabismus were treated with an injection of Botulinum toxin A(Oculinum(R)) into the extraocular muscle under electromyographic control. There were 18 cases of esotropia, 14 of exotropia, 2 of hypertropia, 13 of unila teral abducens nerve palsy and 1 eyeball deviation even after the removal of old intraorbital metalic foreign body. All of the patients were followed up at least 6 months after the injection. By the final visit, the mean correction of preinjection deviation was 52.7% in esotropia, and 56.8% in exotropia, but there was no statistical significance between the two groups. Two patients of hypertropia obtained poor alignment chan ges after the injection. Among 13 patients with sixth nerve palsy, 10 who received injection only obtained mean 53.2% of correction and 3 patients who underwent both the injection and Jensen operation obtained 71.6%. In the one case of old intraorbital foreign body, lateral and inferior deviation before the injection were 60 P.D. and 20 P.D. respectively. After 5 months of injection, it improved to orthophoria and diplopia disappeared at primary position. The most common complication was ptosis, and it occurred in 19 patients(39.5%). Induced vertical deviation had the longest mean duration, lasting for 71.1 dyas. Twelve of 48 patients did not show any complications. No systemic complications were observed in any of the patients.