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

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). 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. 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. 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.