The effectiveness of concomitant strabismus treatment in children with hyperopia by botulinum toxin type A chemodenervation

Purpose. Evaluation of the effectiveness of concomitant strabismus treatment in children with hyperopia by botulinum toxin type A chemodenervation. Materials and methods. The effectiveness of using botulinum toxin type A chemodenervation was studied in 115 children (230 eyes) from 8 months to 15 years old with concomitant convergent strabismus and hyperopic refraction. All patients were divided into 3 groups: group 1–17 patients with strabismus angle up to 15° according to Hirshberg, group 2–34 patients with strabismus angle from 15 to 25° according to Hirshberg, group 3–64 patients with strabismus angle more than 25° according to Hirshberg. All children received an injection of botulinum toxin type A into the horizontal oculomotor muscles at an average dosage of 3.4. Results. In most cases (68.70%), a positive effect was achieved after one injection. Two injections were given to 30 patients (26.09%), 6 patients were given 3 injections (5.22%). Repeated injections, most often (19.13%), were required in patients with a strabismus angle of more than 25 degrees. The effectiveness of strabismus treatment depends on the initial value of the angle and the adequately selected dose. Most often, a positive result of treatment was observed after one injection of botulinum toxin type A with a volume of 2 to 4. We did not find any complications when using the denervation method. Conclusion. The method of botulinum toxin type A chemodenervation is effective in the treatment of concomitant strabismus in children with hyperopia. Key words: botulinum toxin type A, concomitant strabismus, chemodenervation, children, hyperopia.