@article {988041,
	title = {Comparison of Botulinum Toxin With Surgery for the Treatment of Acute-Onset Comitant Esotropia in Children},
	journal = {Am J Ophthalmol},
	volume = {176},
	year = {2017},
	month = {2017 Apr},
	pages = {33-39},
	abstract = {PURPOSE: To determine whether botulinum toxin is as effective as strabismus surgery in the treatment of acute-onset comitant esotropia in children. DESIGN: Retrospective, nonrandomized, comparative clinical study. METHODS: Setting: Tertiary care pediatric hospital. STUDY POPULATION: Forty-nine children with acute-onset comitant esotropia. INTERVENTION: Treatment with either botulinum toxin ("chemodenervation group") or standard incisional strabismus surgery ("surgery group"). MAIN OUTCOME MEASURE: Success rate at 6\&nbsp;months (total horizontal deviation of 10 prism diopters or less and evidence of binocular single vision). RESULTS: There were 16 patients in the chemodenervation group and 33 patients in the surgery group. The success rate was not significantly different at 6\&nbsp;months (81\% vs 61\%, P\&nbsp;= .20) or at 18\&nbsp;months (67\% vs 58\%, P\&nbsp;= .74). The median angle of deviation and median stereoacuity were not significantly different at 6 or 18\&nbsp;months. The chemodenervation procedure was not inferior to incisional strabismus surgery at 6\&nbsp;months. The duration of general anesthesia (5 vs 71\&nbsp;min, P\&nbsp;\&lt;\&nbsp;.001) and time in the post-anesthesia care unit (37 vs 93\&nbsp;min, P \&lt; .001) were significantly shorter in the chemodenervation group. Botulinum toxin injection payment averaged $874 per procedure compared with $2783 for strabismus surgery. CONCLUSIONS: Botulinum toxin is at least as effective as surgery in the treatment of acute-onset comitant esotropia at 6\&nbsp;months while reducing the duration of general anesthesia and healthcare costs.},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2016.12.024},
	author = {Wan, Michael J and Mantagos, Iason S and Shah, Ankoor S and Kazlas, Melanie and Hunter, David G}
}
