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목적 : We investigated the therapeutic effect of botulinum toxin chemodenervation with conjunctival Swan incision without EMG amplifier the treatment of TAO restrictive myopathy patients.
방법 : Between June 2005 and May 2013, 7 strabismus patients with TAO restrictive myopathy were treated with botulinum toxin chemodenervation. Preoperative and postoperative angle of deviation and limitation of eyeball movement were evaluated. Under topical anesthesia with tetracaine(Alcaine®) 5 minutes before surgery and during the procedure, extraocular muscles were exposed with swan conjunctival incision, then extraocular muscle was pulled using two muscle hooks from the sclera. Botulinum toxin was directly injected into the extraocular muscles.
결과 : This study included 3 males and 4 females. The duration of diplopia from restrictive strabismus patients varied from 64.71 ± 41.04 weeks. 7 patients with restrictive strabismus (2 medial rectus muscles, 5 inferior rectus muscles)) were treated with botulinum toxin(Botox® 11.71 ± 2.43 U). After injection, angles of deviation were decreased from 23.64 ± 9.48 PD to 10.57 ± 7.79 PD. (25.70 ± 9.48 PD to 12.00 ± 7.58 PD at horizontal deviation, 18.50 ± 9.19 to 7.00 ± 9.90 at vertical deviation) All patients recovered from central 30° diplopia after treatment.
결론 : Botulinum toxin chemodenervation demonstrated excellent therapeutic effects for TAO restrictive myopathy. Moreover, direct injection on extraocular muscle with simple conjunctival swan incision technique is considered an effective and safe method compared to EMG amplifier guided injection technique.
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