management of duane’s syndrome with botulinum toxin injection

purpose : recession is the main surgical procedure in correction of eye deviation in duane’s syndrome. we evaluate the efficacy of botulinum toxin injection in the treatment of this type of strabismus instead of surgery or before it. methods : three patients with duane’s syndrome type i and one patient with type ii were selected at poostchi eye clinic from patients who diagnosed primarily and had not any eye surgery before. botulinum toxin (dysport™, 10 iu) was injected into medial or lateral rectus muscles under general (2 patients) or local (2 others) anesthesia. amount of deviation, leash phenomenon and limitation of movements were measured pre injection and 72 hours, 1, 4, 12 and 24 weeks postinjections and the results were compared. results : the amount of deviation was decreased between 8-35 pd at 24 weeks postinjection. no significant change was observed in limitation of movement but leash phenomenon improved in 3 patients. conclusion : injection of botulinum toxin in duane’s syndrome will decrease the amount of deviation and leash phenomenon however, surgical intervention maybe necessary for residual deviation or globe retraction.   iranian journal of ophthalmology 200820(3):10-14