Tejedor Jaime, Rodríguez José M
Department of Ophthalmology, Hospital Ramón y Cajal, Carretera Colmenar km 9100, Madrid 28034, Spain.
Arch Ophthalmol. 2007 Sep;125(9):1210-3. doi: 10.1001/archopht.125.9.1210.
To study motor and sensory results of surgery for exotropia following botulinum toxin A injection to correct childhood esotropia.
The medical records of 2445 patients treated with botulinum toxin bimedial injection were retrospectively reviewed to select patients operated on after 1 year of consecutive exotropia. We recorded age at onset of deviation, retinoscopic refractive error, visual acuity and age and dosage at the time of botulinum toxin injection. Retinoscopic refractive error, visual acuity, deviation angle, and stereoacuity before surgery for consecutive exotropia were also recorded. Families were contacted to obtain retinoscopic refraction, visual acuity, deviation angle, Bagolini test, vectography, and stereoacuity data 1 to 8 years after surgery.
A total of 5 children with acquired esotropia and 2 with infantile esotropia were included. A high dose of the toxin per injection might increase the risk of consecutive esotropia. Preoperative mean exotropic deviation was 15.42 prism diopters (PD) (range, 10-25 PD), and stereoacuity was not measurable before surgery. Postoperative mean deviation was 6 PD (range, 4-8 PD), and mean stereoacuity was 447.14 arc seconds. In 2 patients, suppression of the nondominant eye was detected. Three children had poor stereoacuity.
Surgery for exotropia following botulinum toxin injection in children is effective from a motor and sensory point of view.
研究在注射肉毒杆菌毒素A矫正儿童内斜视后进行外斜视手术的运动和感觉结果。
回顾性分析2445例接受双侧肉毒杆菌毒素注射治疗患者的病历，以选择连续外斜视1年后接受手术的患者。我们记录了斜视开始时的年龄、检影验光屈光不正、视力以及肉毒杆菌毒素注射时的年龄和剂量。还记录了连续外斜视手术前的检影验光屈光不正、视力、斜视角度和立体视锐度。联系患者家属以获取术后1至8年的检影验光、视力、斜视角度、Bagolini试验、矢量图和立体视锐度数据。
共纳入5例获得性内斜视儿童和2例婴儿型内斜视儿童。每次注射高剂量毒素可能会增加连续内斜视的风险。术前平均外斜视度数为15.42棱镜度（范围为10 - 25棱镜度），术前立体视锐度无法测量。术后平均斜视度数为6棱镜度（范围为4 - 8棱镜度），平均立体视锐度为447.14角秒。在2例患者中检测到非优势眼抑制。3名儿童立体视锐度较差。
从运动和感觉角度来看，儿童注射肉毒杆菌毒素后进行外斜视手术是有效的。
