Uso coadjuvante de toxina botulínica a intraoperatória na correção monocular de estrabismos horizontais de ângulos grandes sob anestesia local : resultados cirúrgicos / Surgery associated to intraoperative botulinum toxin-a for large angle horizontal strabismus : surgical results

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

29/06/2011

RESUMO

Objective: To investigate the existence of adjuvant effect of botulinum toxin A (5u intraoperative injection) in monocular recess-resection procedure for correction of large angle horizontal strabismus in adults under local anesthesia and to describe types and frequencies of side effects. Subjects and Methods: A randomized clinical trial. Twenty-three patients with large angle horizontal deviations were randomized into two groups: surgery associated with intraoperative injection of botulinum toxin A (CG+BTA) or surgery only (CG). The recess-resection procedures were performed under local anesthesia on the non-fixating eye. The clinical characteristics, amounts of corrections at the last visit (6 to 12 months) and between the first and last visits, the percentages of changes in the pre-operative deviations at 1 day, 7 to 15 days, 1 month, 3 months and 6 to 12 months, the amount of correction between the first and last post operative visits, and the percentages of satisfactory results were compared between groups at the last visit. Results: Means and standard deviations of the preoperative angles of deviation for the groups CG+BTA and CG were 65.8 Dp ± 14.9 and 60.0 Dp ± 16.8 (p=0.26) and the means and standard deviations of the amounts of corrections at the last visit were respectively: 51,5 Dp ± 14,8 and 41,3 Dp ± 14,0 (p=0.18). The percentages of changes in the pre-operative deviations were significantly higher in the CG + TBA group at 30 days (p=0.05), and did not differ between groups at others post operative visits. Amounts of corrections were significantly lower at the last post operative visit in relation to the first for both groups (p=0.006) with no difference between them (p=0.59). There was no difference between groups in the percentage of satisfactory results at the last visit (p=0,63). Side effects of botulinum toxin A more common were: transient ptosis and transient vertical deviation both in 5 of 12 patients treated. Conclusions: Intraoperative injection of TBA did not increase the effect of surgical correction of horizontal strabismus large angles in the patients studied and led to high incidence of ptosis and vertical deviation transitory

ASSUNTO(S)

estrabismo - cirurgia toxina botulinica exotropia esotropia blefaroptose strabismus surgery botulinum toxin exotropia esotropia blepharoptosis

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