Could Botulinum Toxin Be an Effective Primary Treatment for Infantile Esotropia? 

蔡忠斌 Chong-Bin TsaiTaiwan Speaker Could Botulinum Toxin Be an Effective Primary Treatment for Infantile Esotropia?Introduction: To report the long-term success rate of botulinum toxin as the primary treatment for infantile esotropia. Methods: A single-center, retrospective review examined botulinum toxin use in children with esotropia onset before 12 months and presented by age 48 months. Success was defined as ocular alignment within 10 prism diopters (PD) of orthotropia. Results: A total of 35 children received botulinum toxin as primary treatment (1 injection: 63%; 2 injections: 17%; 3 injections: 14%; 4 injections: 6%). Of these, 20 (57%) had only botulinum toxin (BT group), while 15 (43%) had both botulinum toxin and surgery (BT+OP group). The mean deviation at initial presentation was 46.5 ± 13.8 PD in the BT group and 47.3 ± 11.3 PD in the BT+OP group. The mean age for initial botulinum toxin treatment was 1.8 ± 0.8 years for the BT group and 1.5 ± 0.8 years for the BT+OP group. The average follow-up time was 37.3 ± 22.6 months for the entire group. The success rate was 75% (15 of 20) for the BT group and 53% (8 of 15) for the BT+OP group, with no significant difference in success rates between the groups. Conclusions: Botulinum toxin demonstrated a notable long-term success rate as a primary treatment for infantile esotropia. These findings suggest botulinum toxin is an effective initial treatment option, with sustained results observed over an average follow-up of over three years.