| Botulinum alignment for congenital esotropia. | |
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MedLine Citation:
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PMID: 8459999 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Botulinum toxin injection into the medial rectus has been recommended by several investigators as an alternative to incisional surgery for treatment of patients with congenital (essential infantile) esotropia. Currently, there are no published studies demonstrating both the motor and sensory results of congenital esotropic patients aligned by botulinum toxin. METHODS: The author traveled to two medical centers to personally and objectively examine, with standardized testing methods, 12 patients with congenital esotropia who had been aligned for a minimum of 6 months by the age of 2 years by other investigators. The selected patients had been followed for a minimum of 3 years and were of sufficient maturity to reliably respond to sensory testing. A comparison was made between the author's conclusions about the binocularity results of these patients and the assessment of the treating ophthalmologists. RESULTS: Only 6 of the 12 patients demonstrated optimum motor alignment to within 10 prism diopters (PD) of orthophoria at the time of the study. A minimum of 1-month (average, 5 months) post-botulinum injection was found to be necessary to establish this alignment. Only three of these six aligned patients could both fuse and demonstrate gross stereopsis without the assistance of compensatory prisms. These results can be contrasted to a previously reported group of surgically aligned cases in which 66 of 90 patients aligned by 2 years of age could both fuse and demonstrate stereopsis, without any use of compensatory prisms. CONCLUSION: These results must be considered preliminary. However, alignment by botulinum appears to be less effective in establishing evidence for binocularity than incisional surgery in the treatment of congenital esotropia (P < 0.001). |
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Authors:
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M R Ing |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ophthalmology Volume: 100 ISSN: 0161-6420 ISO Abbreviation: Ophthalmology Publication Date: 1993 Mar |
Date Detail:
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Created Date: 1993-04-29 Completed Date: 1993-04-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 318-22 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Botulinum Toxins
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therapeutic use* Child Child, Preschool Depth Perception / drug effects Esotropia / congenital*, physiopathology, therapy* Female Follow-Up Studies Humans Injections Male Muscle Denervation Oculomotor Muscles / drug effects Treatment Outcome Vision, Binocular / drug effects Visual Acuity / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Botulinum Toxins |
| Comments/Corrections | |
Comment In:
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Ophthalmology. 1993 Aug;100(8):1119
[PMID:
8341487
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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