Botulinum Toxin-Augmented Strabismus Surgery versus Conventional Surgery in the Treatment of Large-Angle Infantile Esotropia

The treatment of large-angle infantile esotropia remains a challenge. Surgical treatment traditionally has involved either threemuscle surgery or supra-maximal medial rectus recessions, but both methods have significant drawbacks including risk of overor undercorrection. An alternative is to use botulinum toxin to weaken the medial rectus muscles, but multiple treatments are often required and the success rate for large deviations is poor. It has been suggested that the best approach may be to combine these treatments. No previous study has directly compared botulinum toxin-augmented surgery to conventional surgery alone.