Botulinum toxin type-A injection associated with surgical treatment in large angle strabismus

Purpose: surgical treatment of large angle strabismus uses the traction sutures, to maintain the eyeball in hypercorrected position for several days postoperatively [1]. The use of intraoperative botutinum toxin type-A (BTA) may represent an effective alternative [2]. Design: to value the results of intraoperative BTA in 8 patients with large angle strabismus. Methods: 8 adults patients, two with large angle esotropia (+80Delta), two with esotropia in high myopia, two with VI nerve palsy and two with dysthyroid ophthalmopathy, underwent to a surgical procedure with a single intraoperative BTA injection. Results: after 10 days in 7 patients the postoperative follow-up showed an hypercorrection which was reduced within 2-6 months and after 8 months in all cases the return of orthophoria and disappearance of preoperative diplopia.