Long-Term Effects of Botulinum Toxin in Large-Angle Infantile Esotropia

PURPOSE: The purpose of this study is the motor outcome analysis of early Botulinum toxin (BT) treatment in patients affected by large-angle infantile esotropia (IE). PATIENTS AND METHODS: Retrospective analysis of 130 medical charts of IE patients who underwent BT injections between 2004 and 2019 was performed. All patients underwent BT injections within 13 months of age. RESULTS: Thirty patients, matching the inclusion criteria, were included in the study. Twenty-eight patients showing residual ET ≥25 PD (34.3±6.6 PD ranged from 25 to 50) underwent surgery. CONCLUSION: Our result after 1 Botulinum toxin injection showed a very low success rate (6.7%) at last follow-up (28.3±7.2 months). Our data would suggest one Botulinum toxin injection in children affected by large-angle infantile esotropia allows a significant reduction of deviation but does not avoid the need for surgical treatment.