Comparison of Botulinum Toxin With Surgery for the Treatment of Acute-Onset Comitant Esotropia in Children.
Am J Ophthalmol
; 176: 33-39, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28057455
ABSTRACT
PURPOSE:
To determine whether botulinum toxin is as effective as strabismus surgery in the treatment of acute-onset comitant esotropia in children.DESIGN:
Retrospective, nonrandomized, comparative clinical study.METHODS:
Setting:
Tertiary care pediatric hospital. STUDY POPULATION Forty-nine children with acute-onset comitant esotropia. INTERVENTION Treatment with either botulinum toxin ("chemodenervation group") or standard incisional strabismus surgery ("surgery group"). MAIN OUTCOMEMEASURE:
Success rate at 6 months (total horizontal deviation of 10 prism diopters or less and evidence of binocular single vision).RESULTS:
There were 16 patients in the chemodenervation group and 33 patients in the surgery group. The success rate was not significantly different at 6 months (81% vs 61%, P = .20) or at 18 months (67% vs 58%, P = .74). The median angle of deviation and median stereoacuity were not significantly different at 6 or 18 months. The chemodenervation procedure was not inferior to incisional strabismus surgery at 6 months. The duration of general anesthesia (5 vs 71 min, P < .001) and time in the post-anesthesia care unit (37 vs 93 min, P < .001) were significantly shorter in the chemodenervation group. Botulinum toxin injection payment averaged $874 per procedure compared with $2783 for strabismus surgery.CONCLUSIONS:
Botulinum toxin is at least as effective as surgery in the treatment of acute-onset comitant esotropia at 6 months while reducing the duration of general anesthesia and healthcare costs.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Oftalmológicos
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Visão Binocular
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Acuidade Visual
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Esotropia
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Músculos Oculomotores
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Ophthalmol
Ano de publicação:
2017
Tipo de documento:
Article