Comparative efficacy of botulinum toxin injection versus extraocular muscle surgery in acute acquired comitant esotropia
10.3980/j.issn.1672-5123.2025.11.02
- VernacularTitle:肉毒杆菌毒素注射与眼外肌手术治疗急性共同性内斜视的疗效对比
- Author:
Tianyi LIU
1
;
Yue ZHOU
1
;
Pengzhou KUAI
1
;
Yangchen GUO
1
;
Xiaobo HUANG
1
;
Yong WANG
1
;
Xin CAO
1
Author Information
1. Affiliated Hospital 2 of Nantong University;First People's Hospital of Nantong, Nantong 226001, Jiangsu Province, China
- Publication Type:Journal Article
- Keywords:
botulinum toxin A;
acute acquired esotropia;
extraocular muscle surgery
- From:
International Eye Science
2025;25(11):1721-1727
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To investigate the therapeutic effects of botulinum toxin A(BTXA)injection versus strabismus surgery in the treatment of acute acquired comitant esotropia(AACE).METHODS:Patient records of AACE cases treated at First People's Hospital of Nantong from January 2019 to September 2023 were retrospectively analyzed in this study. Patients were categorized into either strabismus surgery or BTXA injection groups based on treatment modality. Further stratification was performed according to preoperative deviation angles [>35 prism diopters(PD)vs ≤35 PD] and age(≥18 years adult group vs <18 years adolescent group). The baseline patient characteristics were collected, deviation angles at multiple timepoints before and after treatment were measured, and stereopsis test results were documented. Through comparative analysis of therapeutic outcomes across subgroups, we systematically evaluated the efficacy of different treatment approaches.RESULTS:A total of 43 AACE patients were included. At the final follow-up, both the surgery and BTXA injection groups showed a statistically significant decrease in deviation angle compared to pretreatment measurements(P<0.001). Significant differences were noted between the two groups in terms of the cure rate of strabismus and the recovery rate of stereopsis(P<0.05). For patients with deviations >35 PD, surgery yielded significantly better outcomes than injection therapy in postoperative angle, success rate, and stereopsis recovery(P<0.05). Similarly, in patients aged ≥18 years, surgical treatment was superior to injections in reducing strabismus angle, improving success rates, and restoring stereopsis(P<0.05).CONCLUSION:Both BTXA injection and strabismus surgery demonstrate therapeutic efficacy in AACE. Surgical treatment demonstrated superior efficacy compared to BTXA injection therapy, particularly in patients with deviations >35 PD and those aged ≥18 years. For patients with angles ≤35 PD or under 18 years, BTXA injection remains a viable treatment option.
