[Observation of botulinum toxin A management in childhood with intermittent exotropia]

Abstract

Objective: To observe the effect of botulinum toxin A (BTXA) management in childhood with intermittent exotropia.

Methods: A prospective non-random clinical study was performed in 60 children aged from 4 to 12 years, who diagnosed to be intermittent exotropia. Patients were divided into surgery groups and BTXA group according to the intention of patient's parent. The recession of bilateral rectus muscle was performed in 30 patients in surgery group. BTXA injection into bilateral rectus muscle was performed in 30 patients in BTXA group. Eye alignment and the binocular vision were evaluated 6 months after the treatments.

Results: In BTXA group, the deviation was (-41.33 +/- 12.17)Delta (-30Delta to -75Delta) at the baseline, and (6.23 +/- 9.80)Delta (-30Delta to 0Delta) 6 month after BTXA injection. Among the patients, 7 cases were under-correct. In surgery group, the deviation was (-42.83 +/- 11.72)Delta (-25Delta to -80Delta) at the baseline, and (2.67 +/- 5.21)Delta (-15Delta to +15Delta) 6 months after surgery. Among these patients, 1 case was under-corrected, and 2 cases were overcorrected. The recovery rate was 76.67% and 90.00% respectively in BTXA and surgery group, and was no statistically significant difference these two groups (P = 0.177) and the recovery rate (chi2 = 0.42, P = 0.166). Some patients were found to have fusion and distance stereopsis re-built, while some others were found to have near stereopsis improvement in both groups.

Conclusion: BTXA injection is a rapid, less invasive and effective procedure for the intermittent exotropia.