OBSERVATIONS ON BILATERAL SIMULTANEOUS BOTULINUM TOXIN INJECTION IN INFANTILE ESOTROPIA

Botulinum toxin (BoTX) is an effective pharmacological alternative to the surgical management of strabismus in adults. In a previous study, we found that concurrent bilateral medial rectus muscle BoTX injection s for infantile esotropia could produce stable ocular realignment with out significant risk. No other investigators have used bilateral simul taneous BoTX injection. We report the results of bilateral simultaneou s medial rectus BoTX injection in 57 infantile esotropia patients foll owed for a minimum of 12 months. The esotropic angle in 27 infantile e sotropia patients under 12 months of age was reduced from 43 +/- 12 to 1 +/- 2 prism diopters. The esotropic angle in 30 infantile esotropia patients at a mean age of 24 months was reduced from 31 +/- 12 to 2 /- 3 DELTA. Other variables including late onset of hyperopic refracti ve errors, dissociated vertical deviations, overacting oblique muscles , and consecutive exodeviations are evaluated. We regard BoTX as relia ble therapy in infantile esotropia.