Presence of Fusion in Albinism after Strabismus Surgery Augmented with Botulinum Toxin (Type A) Injection
Case 1 was an 18-year-old girl with refraction in her right and left eye of +4.0 / -1.5 × 180° and +4.0 / -2.0 × 180°, respectively, and a best-corrected visual acuity (BCVA) of 2 / 10 in both eyes. Examination showed 45Δ exotropia and 8Δ hypotropia in the left eye due to an overactive superior oblique muscle and no fusion. She underwent 8 mm bilateral lateral rectus recession, left superior oblique posterior tenotomy, and intraoperative bilateral 12.5 U BTA (Dysport; Ipsen Laboratories, Porton, UK) injection to these muscles with no complications. Follow-up examinations revealed 8Δ left esotropia at 2 weeks and 1 month, and 6Δ left exotropia at month 4, which remained constant up to 12 months. The patient demonstrated fusion on Bagolini test (). Before surgery, the patient had no perception in the Bagolini test; however, at 4 months after surgery, the patient was able to perceive the major parts of both arms of the X generated by Bagolini lenses, despite small areas of suppression around the fixation light.