Cochrane · systematic review · CD006499
Botulinum toxin for the treatment of strabismus
Bort-Martí, AR, Rowe, FJ, Ruiz Sifre, L, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
6
current version
GRADE rated
4
No studies
2
Included studies
NR
No studies 2 · 33.3%Ungraded 0 · 0%Very low 1 · 16.7%Low 3 · 50%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyBotulinum toxin versus surgery
Population: adults and children with strabismus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Improved or corrected strabismusa at 6 or 12 months Botulinum toxin vs surgery | RR 0.72 [0.53, 0.99] | 4 studies · 242 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events at 6 or 12 months Botulinum toxin vs surgery | no estimate extracted | NR | No studies |
Proportion of participants requiring additional surgery(ies) at 6 or 12 months Botulinum toxin vs surgery | RR 3.05 [1.34, 6.91] | 1 study · 101 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants who achieved binocular single vision at 6 or 12 months Botulinum toxin vs surgery | RR 0.88 [0.63, 1.23] | 2 studies · 102 participants | Low Downgraded: risk of bias, imprecision |
Quality of life, as measured by validated instruments Botulinum toxin vs surgery | no estimate extracted | NR | No studies |
Non‐serious adverse events at 6 or 12 months Botulinum toxin vs surgery | no estimate extracted | 3 studies · 212 participants | Low |
Botulinum toxin versus surgery
Population: adults and children with strabismus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: improved ocular alignment ≤ 10 PD Botulinum toxin vs surgery | no estimate extracted | NR | No studies |
Secondary outcome: achievement of binocular single vision Botulinum toxin vs surgery | RR 0.88 [0.63, 1.23] | 2 studies · 102 participants | Low Downgraded: risk of bias |
Secondary outcome: achievement of 'sensory' fusion Botulinum toxin vs surgery | RR 0.88 [0.63, 1.23] | 2 studies · 102 participants | Low Downgraded: risk of bias |
Secondary outcome: achievement of stereopsis Botulinum toxin vs surgery | RR 0.86 [0.59, 1.25] | 2 studies · 102 participants | Low Downgraded: risk of bias |
Adverse events with botulinum toxin Botulinum toxin vs surgery | no estimate extracted | 2 studies · 102 participants | Low Downgraded: risk of bias |
Botulinum toxin versus observation
Population: adults with strabismus due to acute onset sixth nerve palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: improved ocular alignment ≤ 10 PD Botulinum toxin vs observation | RR 1.19 [0.96, 1.48] | 1 study · 47 participants | Low Downgraded: risk of bias |
Secondary outcome: achievement of binocular single vision Botulinum toxin vs observation | RR 1.19 [0.96, 1.48] | 1 study · 47 participants | Low Downgraded: risk of bias |
Secondary outcome: achievement of 'sensory' fusion Botulinum toxin vs observation | no estimate extracted | 0 participants | Ungraded |
Secondary outcome: achievement of stereopsis Botulinum toxin vs observation | no estimate extracted | 0 participants | Ungraded |
Adverse events with botulinum toxin Botulinum toxin vs observation | no estimate extracted | 1 study · 47 participants | Low Downgraded: risk of bias |
Surgery with botulinum toxin versus surgery without botulinum toxin
Population: adults with strabismus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: improved ocular alignment ≤ 10 PD Surgery with botulinum toxin vs surgery without botulinum toxin | RR 1.83 [0.41, 8.11] | 1 study · 23 participants | Very low Downgraded: risk of bias |
Secondary outcome: achievement of binocular single vision Surgery with botulinum toxin vs surgery without botulinum toxin | no estimate extracted | NR | No studies |
Secondary outcome: achievement of 'sensory' fusion Surgery with botulinum toxin vs surgery without botulinum toxin | no estimate extracted | NR | No studies |
Secondary outcome: achievement of stereopsis Surgery with botulinum toxin vs surgery without botulinum toxin | no estimate extracted | NR | No studies |
Adverse events with botulinum toxin Surgery with botulinum toxin vs surgery without botulinum toxin | no estimate extracted | 1 study · 23 participants | Low Downgraded: risk of bias |
Botulinum toxin with sodium hyaluronate versus botulinum toxin without sodium hyaluronate
Population: children with strabismus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: improved ocular alignment ≤ 10 PD Botulinum toxin with sodium hyaluronate vs botulinum toxin without sodium hyaluronate | RR 0.81 [0.36, 1.82] | 1 study · 47 participants | Low Downgraded: risk of bias |
Secondary outcome: achievement of binocular single vision Botulinum toxin with sodium hyaluronate vs botulinum toxin without sodium hyaluronate | no estimate extracted | NR | No studies |
Secondary outcome: achievement of 'sensory' fusion Botulinum toxin with sodium hyaluronate vs botulinum toxin without sodium hyaluronate | no estimate extracted | NR | No studies |
Secondary outcome: achievement of stereopsis Botulinum toxin with sodium hyaluronate vs botulinum toxin without sodium hyaluronate | no estimate extracted | NR | No studies |
Adverse events with botulinum toxin Botulinum toxin with sodium hyaluronate vs botulinum toxin without sodium hyaluronate | no estimate extracted | 1 study · 47 participants | Low Downgraded: risk of bias |