Gardner Richard, Dawson Emma L, Adams Gillian G, Lee John P
Moorfields Eye Hospital, London, EC1V 2PD United Kingdom.
Strabismus. 2013 Mar;21(1):8-12. doi: 10.3109/09273972.2012.742118.
Persistent symptomatic strabismus may be seen in up to 25% of patients post retinal detachment surgery. Surgical correction of ocular misalignment in this situation can be technically difficult to perform and the results are less predictable than in other forms of strabismus surgery. We report on our experience of the use of botulinum toxin injections as an alternative.
A retrospective review was made of all patients who had received botulinum toxin injections in the management of their strabismus following retinal detachment surgery at our institution between November 1982 and January 2006. One hundred and forty patients fulfilled our criteria with a mean length of follow-up of 27 months. Thirty-three patients (23.6%) were symptom free following botulinum toxin injection alone and were discharged from the clinic, 50.5% of these after only 2 injections. Fusion was regained in 37.9%. The only factor associated with lack of restoration of fusion in the multivariate analysis was visual acuity in the injected eye. Complications were seen in 2.9% of patients.
Botulinum toxin injections may represent a safe and acceptable alternative to surgery and may be particularly useful for those in whom surgery is contraindicated or not desired.
视网膜脱离手术后，高达25%的患者可能会出现持续性症状性斜视。在这种情况下，手术矫正眼位偏斜在技术上可能难以实施，而且与其他形式的斜视手术相比，结果更难预测。我们报告了使用肉毒杆菌毒素注射作为替代方法的经验。
对1982年11月至2006年1月期间在我院接受视网膜脱离手术后因斜视接受肉毒杆菌毒素注射治疗的所有患者进行了回顾性研究。140例患者符合我们的标准，平均随访时间为27个月。仅接受肉毒杆菌毒素注射后症状消失并出院的患者有33例（23.6%），其中50.5%仅注射2次后即症状消失。37.9%的患者恢复了融合功能。多因素分析中，与融合功能未恢复相关的唯一因素是注射眼的视力。2.9%的患者出现了并发症。
肉毒杆菌毒素注射可能是一种安全且可接受的手术替代方法，对于那些手术禁忌或不愿接受手术的患者可能特别有用。
