Session: Poster session B

Botulinum Toxin Treatment of Consecutive Exotropia 

Introduction: To assess the efficacy of botulinum toxin type A (BTA) injection as a re-treatment procedure in patients with consecutive exotropia.

Methods: The medical records of 34 patients who underwent BTA injection for consecutive exotropia were retrospectively reviewed. 5 units of BTA was applied to the unilateral lateral rectus muscle and the injection was administered under electromyography guidance. Successful motor alignment was defined as far deviation within 10 PD.

Results: A total of 34 patients were included in the study. Twenty six patients (76.5%) had acquired esotropia, 8 patients (23.5%) had infantile esotropia. The average age of the patients was 18.3±22.6 months. The mean time elapsed between the last surgery and botulinum toxin injection 67.8±78 months (range 0.3 to 252 months). The mean pre-BTA injection deviation was 20.03±8.42 PD at near and 21.41±8.87 PD at distance. The post-BTA injection deviation was 9.65±7.42 PD at near and 10.82±7.33 PD at distance. All the patients were followed up with 19.8±20 months (range 6 to 84 months). The average number of injections was 1.6±1.1. Of 34 patients, 22 (64.7%)had only one injection and 12 (35.3%) had multiple injections. In patients with single injection, successful alignment was achieved in 16 patients (72.7%). Final success rate was 70.6 %. Of 34 injections of botulinum toxin, in two patients transient mild ptosis and in one patient transient diplopia were observed.

      Conclusion: The results of this study demonstrates that BTA injection can be an effective, safe treatment option in consecutive exotropia.