Suwannaraj Sirinya, Rojanasaksothron Chawisa, Methapisittikul Yanasiri, Wongwai Phanthipha, Yospaiboon Yosanan
KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Clin Ophthalmol. 2023 Jan 31;17:413-420. doi: 10.2147/OPTH.S401019. eCollection 2023.
To compare the success rate of extraocular muscle surgery and botulinum toxin injection for treatment in patients with acute acquired comitant esotropia (AACE).
This is a retrospective cohort study in which we treated 34 patients of AACE with botulinum toxin compared with 80 patients who had been treated with surgery. The data included angle of deviation in prism diopter (PD) at baseline and one, three, and six months after treatment. The main outcome was the success rate in each treatment group.
In the surgery group, mean esodeviation angles at baseline and one, three, and six months after treatment were 50.8 ± 18.3 PD, 4.9 ± 8.3 PD, 4.6 ± 9.5 PD, and 5.5 ± 10.3 PD, whereas those in the botulinum toxin group were 51.2 ± 14.3 PD, 13.9 ± 17.4 PD, 22.0 ± 19.3, and 31.3 ± 23.8 PD, respectively. There was a statistically significant difference in the deviation angles between the two groups ( < 0.001). The success rate in the surgery group at one, three, and six months was 81%, 84%, and 79%, whereas that in the botulinum toxin group was 50%, 27%, and 27%.
Botulinum toxin injection was not as effective as conventional extraocular muscle surgery in AACE patients. However, the treatment is safe, fast-acting, and improves both cosmetic appearance and quality of life. This may be considered as a chance for patients not preferring surgery.
比较眼外肌手术和肉毒杆菌毒素注射治疗急性后天性共同性内斜视（AACE）患者的成功率。
这是一项回顾性队列研究，我们用肉毒杆菌毒素治疗了34例AACE患者，并与80例接受手术治疗的患者进行比较。数据包括治疗前基线以及治疗后1个月、3个月和6个月时的棱镜度（PD）斜视角度。主要结局是每个治疗组的成功率。
手术组治疗前基线以及治疗后1个月、3个月和6个月时的平均内斜视角度分别为50.8±18.3 PD、4.9±8.3 PD、4.6±9.5 PD和5.5±10.3 PD，而肉毒杆菌毒素组分别为51.2±14.3 PD、13.9±17.4 PD、22.0±19.3 PD和31.3±23.8 PD。两组之间的斜视角度存在统计学显著差异（<0.001）。手术组在1个月、3个月和6个月时的成功率分别为81%、84%和79%，而肉毒杆菌毒素组分别为50%、27%和27%。
在AACE患者中，肉毒杆菌毒素注射不如传统的眼外肌手术有效。然而，该治疗方法安全、起效快，可改善外观和生活质量。对于不倾向于手术的患者，这可被视为一个选择。
