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Clinical Trial
. 2020 Aug;68(8):1600-1603.
doi: 10.4103/ijo.IJO_1552_19.

Short-term outcome of botulinum neurotoxin A injection with or without sodium hyaluronate in the treatment of infantile esotropia-a prospective interventional study

Nitika Pandey  1 , Siddharth Agrawal  1 , Rajat M Srivastava  1 , Vinita Singh  1
Affiliations
Clinical Trial

Short-term outcome of botulinum neurotoxin A injection with or without sodium hyaluronate in the treatment of infantile esotropia-a prospective interventional study

Nitika Pandey et al. Indian J Ophthalmol. 2020 Aug.

Abstract

Purpose: To compare the short-term outcome of botulinum neurotoxin A (BoNT-A) with or without sodium hyaluronate in the treatment of infantile esotropia (IE).

Methods: In this tertiary care hospital-based prospective, interventional, non-randomized study on infants with IE below one year of age, 25 cases were enrolled in the sodium hyaluronate (SH) group to receive 2.5 U BoNT-A injection combined with SH in each medial rectus muscle (MR). Thirty patients were enrolled in the control group to receive 2.5 U BoNT-A injection with normal saline in each MR. The change in mean primary ocular deviation (POD) and complications were assessed at 2 weeks, 1 month, 3 months, and 6 months post injection. Mann-Whitney U test was used for non-parametric unpaired data. Chi-square test and Fisher's exact test were used to test for the strength of the association between the two categorical variables.

Results: Satisfactory ocular alignment was achieved in 76% in SH group and 73% in the control group (P value = 0.80). While the change in mean POD was comparable (29.2 prism diopters [PD] vs 29.3 PD; P value = 0.65), the complication rates were significantly lesser in SH (16% vs 33.3%; P value = 0.14).

Conclusion: BoNT-A combined with SH is equally effective with lesser complications as compared to botulinum toxin alone in the treatment of IE.

Keywords: Botulinum toxin; infantile esotropia; sodium hyaluronate.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Botulinum toxin A injection with Sodium Hyaluronate (SH) (a) Pre-injection deviation (b) Successful ocular alignment at 6 months
Figure 2
Figure 2
Botulinum toxin A injection alone (Control): (a) pre-injection deviation, (b) Severe ptosis 2 weeks post-botulinum toxin A injection, (c) Successful ocular alignment after 6 months
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