PMID- 38447598
OWN - NLM
STAT- Publisher
LR  - 20240331
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Linking)
VI  - 263
DP  - 2024 Mar 4
TI  - A Comparison of Chemodnervation to Incisional Surgery for Acute, Acquired, 
      Comitant Esotropia: An International Study.
PG  - 160-167
LID - S0002-9394(24)00092-8 [pii]
LID - 10.1016/j.ajo.2024.02.036 [doi]
AB  - PURPOSE: To compare the efficacy of botulinum toxin injections to strabismus 
      surgery in children with acute, acquired, comitant esotropia (ACE), and to 
      investigate factors predicting success. DESIGN: International, multi-center 
      nonrandomized comparative study METHODS: Setting: Cloud-based survey. STUDY 
      POPULATION: Children aged 2 to 17 years who underwent a single surgical 
      intervention for ACE. INTERVENTIONS: Botulinum toxin injection 
      ("chemodenervation" group) or strabismus surgery ("surgery" group). MAIN OUTCOME 
      MEASURES: Primary measure: success rate at 6 months in propensity-matched cohort, 
      defined as total horizontal deviation of 10 prism diopters or less with evidence 
      of binocular single vision. Secondary measure: Risk factors for poor outcomes in 
      the full cohort. RESULTS: Surgeons from 19 centers contributed. There were 74 
      patients in the chemodenervation group and 97 patients in the surgery group. In 
      the propensity-matched data (n = 98), success rate was not significantly 
      different at 6 months (70.2% vs 79.6%; P = .2) and 12 months (62.9% vs 77.8%; P = 
      .2), but was significantly lower in the chemodenervation group at 24 months (52% 
      vs 86.4%; P = .015). Irrespective of treatment modality, treatment delay was 
      associated with lower success rates at 6 months, with median time from onset to 
      intervention 4.5 months (interquartile range (IQR): 2.1, 6.7) in the success 
      group and 7.7 months (IQR: 5.6, 10.1) in the failure group (P < .001). 
      CONCLUSIONS: In children with ACE, success rate after chemodenervation was 
      similar to that of surgery for up to 12 months but lower at 24 months. Those with 
      prompt intervention and no amblyopia had the most favorable outcomes, regardless 
      of treatment modality.
CI  - Copyright (c) 2024 Elsevier Inc. All rights reserved.
FAU - Cheung, Crystal S Y
AU  - Cheung CSY
AD  - From the Department of Ophthalmology (C.C, L.D, A.S, D.H), Harvard Medical School 
      and Boston Children's Hospital, Boston, Massachusetts, USA; Department of 
      Ophthalmology and Vision Science (C.C, M.W), University of Toronto and Hospital 
      for Sick Children, Toronto, Ontario, Canada.
FAU - Wan, Michael J
AU  - Wan MJ
AD  - Department of Ophthalmology and Vision Science (C.C, M.W), University of Toronto 
      and Hospital for Sick Children, Toronto, Ontario, Canada.
FAU - Zurakowski, David
AU  - Zurakowski D
AD  - Departments of Anesthesiology and Surgery, Boston Children's Hospital (D.Z), 
      Harvard Medical School, Boston, Massachusetts, USA.
FAU - Kodsi, Sylvia
AU  - Kodsi S
AD  - Department of Ophthalmology (S.K), Northwell Health, Great Neck, New York, USA.
FAU - Ekdawi, Noha S
AU  - Ekdawi NS
AD  - Department of Ophthalmology (N.E), Wheaton Eye Clinic, Wheaton, Illinois, USA.
FAU - Russell, Heather C
AU  - Russell HC
AD  - Faculty of Health Sciences & Medicine, Bond University and Department of 
      Ophthalmology (H.R), Gold Coast University Hospital, Gold Coast, Australia.
FAU - Shetty, Shashikant
AU  - Shetty S
AD  - Paediatric Ophthalmology (S.S), Aravind Eye Hospital, Madurai, Tamil Nadu, India.
FAU - Dumitrescu, Alina V
AU  - Dumitrescu AV
AD  - Department of Ophthalmology (A.D), University of Iowa, Iowa City, Iowa, USA.
FAU - Dagi, Linda R
AU  - Dagi LR
AD  - From the Department of Ophthalmology (C.C, L.D, A.S, D.H), Harvard Medical School 
      and Boston Children's Hospital, Boston, Massachusetts, USA.
FAU - Shah, Ankoor S
AU  - Shah AS
AD  - From the Department of Ophthalmology (C.C, L.D, A.S, D.H), Harvard Medical School 
      and Boston Children's Hospital, Boston, Massachusetts, USA.
FAU - Hunter, David G
AU  - Hunter DG
AD  - From the Department of Ophthalmology (C.C, L.D, A.S, D.H), Harvard Medical School 
      and Boston Children's Hospital, Boston, Massachusetts, USA. Electronic address: 
      david.hunter@childrens.harvard.edu.
CN  - AACE Outcomes Consortium
LA  - eng
PT  - Journal Article
DEP - 20240304
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
SB  - IM
EDAT- 2024/03/07 00:42
MHDA- 2024/03/07 00:42
CRDT- 2024/03/06 19:12
PHST- 2023/11/27 00:00 [received]
PHST- 2024/02/24 00:00 [revised]
PHST- 2024/02/25 00:00 [accepted]
PHST- 2024/03/07 00:42 [pubmed]
PHST- 2024/03/07 00:42 [medline]
PHST- 2024/03/06 19:12 [entrez]
AID - S0002-9394(24)00092-8 [pii]
AID - 10.1016/j.ajo.2024.02.036 [doi]
PST - aheadofprint
SO  - Am J Ophthalmol. 2024 Mar 4;263:160-167. doi: 10.1016/j.ajo.2024.02.036.