肉毒毒素注射治疗急性共同性内斜视的临床效果

Clinical efficacy of the injection of botulinum toxin in the treatment of acute comitant esotropia

目的评价无肌电图引导直视下球结膜小切口注射A型肉毒毒素治疗急性共同性内斜视的临床效果.方法回顾性分析徐州市第一人民医院2018年6月至2019年11月收治急性共同性内斜视41例(71眼)的临床资料.患者均行内直肌肉毒素注射术,术后随访3个月.结果术前内斜视度数为43.54△±13.63△,术后3个月34例(82.93%)眼位正位,复视消失,6例(14.63%)斜视明显好转,1例(2.43%)无效.术后2周3例(7.31%)出现上睑下垂,3例(7.31%)出现过矫,术后1个月上睑下垂和过矫均恢复.结论无肌电图引导直视下球结膜小切口注射A型肉毒毒素治疗急性共同性内斜视临床效果良好.

Objective To evaluate the clinical efficacy of minimally invasive injection of botulinum toxin type A(BTXA)through bulbar conjunctiva without electromyography guidance for the treatment of acute comitant esotropia(ACE).Methods The clinical data of 71 eyes of 41 ACE patients treated with BTXA in Xuzhou No.1 People’s Hospital from Jun.2018 to Nov.2019 were analyzed retrospectively.All patients were treated with medial rectus injection of BTXA,and followed up for 3 months after operation.Results The average strabismus before treatment was 43.54△±13.63△.At 3 months after the injection,34 cases(82.93%)were straightened out to normal position,and the symptoms of diplopia disappeared.Six cases(14.63%)of esotropia alleviated obviously,and 1 case(2.43%)was not respond to injections.At 2 weeks postoperatively,ptosis occured in 3 cases(7.31%),over-correction occured in 3 cases(7.31%).At 1 month after operation,the above symptoms disappeared.Conclusion The injection of BTXA into medical rectus by minimally invasive surgery through bulbar conjunctiva without EMG for ACE is effective.