Long-term treatment of strabismus with Botox

A long-term course of injections of botulinum toxin ("Botox") offers a viable treatment for complicated strabismus, according to study results published in the December 2008 issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

John P. Lee, FRCS, FRCP, FRCOphth of Moorfields Eye Hospital, London, UK and colleagues conducted a retrospective review to identify strabismic patients receiving a minimum of 25 botulinum toxin injections between November 1982 and January 2006, and compared treatment outcomes of this group with those receiving fewer injections.

The duration of treatment was 3–22 years, and the team found that there was no statistically significant difference in the complication rate of the 57 patients receiving ≥25 injections when compared with patients receiving fewer injections. The number of injections required decreased over time. Patients in the group receiving ≥25 injections were found to have a greater amount of previous operations and a lower level of binocularity.

Thus the team concluded that long-term botulinum toxin injection therapy is safe for the treatment of strabismus, and may be the most appropriate treatment course for the management of complicated strabismus, or those with either multiple previous operations or poor binocular potential.