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  • Efficacy of augmented-dosed surgery versus botulinum toxin A injection for acute acquired concomitant esotropia: a 2-year follow-up

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Neuro-ophthalmology and strabismus
Efficacy of augmented-dosed surgery versus botulinum toxin A injection for acute acquired concomitant esotropia: a 2-year follow-up
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  • Published on: 20 June 2024
    Use of standard surgical tables for AACE
    • Hennaav K Dhillon, Ophthalmologist Medical Research Foundation, Sankara Nethralaya, Chennai
    • Other Contributors:
      • Ria Sharma, Ophthalmologist
      • Pragya Singh, Ophthalmologist
      • Sumita Agarakar, Ophthalmologist
      • Akshay Badakere, Ophthalmologist

    26th September 2023

    Dear Editor,
    We read with great interest the study conducted by Yu X et al.1 comparing the efficacy of augmented surgical doses of surgery and Botulinum Toxin A injection for Acute acquired concomitant esotropia (AACE).
    AACE has been on the rise with the advent of digital education for children, smartphones and change in lifestyles for both adults and children and hence this work is of particular interest to us.
    We wish to report outcomes from our unpublished series of acquired esotropia. We retrospectively analyzed 29 patients of AACE, over a 17 month period between April 2022 and September 2023. As per protocol, we used surgical doses suggested by standard tables and did not use augmentation. The mean angle of deviation was 43.09  9.32 PD at 6m and 46.31 9.8 PD at 33cm preoperatively. The mean dose response without augmentation we achieved was 3.12 0.62 PD/mm and we achieved surgical success in 28 patients. The post operative final angles of deviation were 3.33  5.81 PD at 6m and 4.05-6.64 PD at 33cm at the last follow up. We used similar criteria of surgical success as Yu X et al.
    Kim et al also report successful surgical outcomes in their subset of AACE patients using standard doses from Park’s tables.3
    Augmented surgery has also been done by either increasing the amount of recession or resection and has resulted in good motor and sensory outcomes4,5
    Yu et al recommend augmenting their surgical dose by...

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    Conflict of Interest:
    None declared.