Botulinum neurotoxin A injection for the treatment of epiphora with patent lacrymal ducts

Girard, B.; Piaton, J.-M.; Keller, Pierre; Nguyen, T.H.

doi:10.1016/j.jfo.2017.11.010

Cited by 23 publications

(16 citation statements)

References 21 publications

(11 reference statements)

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“…Regarding the adverse effects of BTX-A injections, our results are consistent with previous reports of about 10% of patients experiencing temporary ptosis and diplopia that typically last for 2-4 weeks [8,9,14]. Also, there have been reports that performing a transcutaneous injection without direct visualization of the lacrimal gland might increase the risk of paresis of the levator palpebrae superioris and extraocular muscles [15,16].…”

Section: Discussionsupporting

confidence: 91%

Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial

Lee

Jang

et al. 2021

Toxins

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The purpose of this study was to determine and compare the effects between injecting botulinum toxin A (BTX-A) transconjunctivally into the palpebral lobe and transcutaneously into the orbital lobe of the lacrimal gland in patients with epiphora due to lacrimal outflow obstruction. This randomized controlled study included 53 eyes of 31 patients with unilateral or bilateral epiphora. Patients were randomly allocated to receive an injection of BTX-A (3 units) either transconjunctivally (n = 15, 25 eyes) or transcutaneously (n = 16, 28 eyes). For objective assessments, the tear meniscus height and Schirmer’s I test with topical anesthesia were measured at baseline and after 2, 6, 12, and 24 weeks of follow-up. Subjective evaluations were performed using the Munk score. After BTX-A injection, patients in both groups experienced significant objective and subjective reductions in tearing at all follow-up times compared to pre-injection (success rate 86.8%), and the effect lasted for a mean duration of 5.63 months. The two delivery routes showed similar clinical effectiveness for a single injected dose of BTX-A. In conclusion, injecting BTX-A via either a transconjunctival or transcutaneous route helps to reduce normal tear production and results in significant improvements in the symptoms in patients with epiphora.

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Section: Discussionsupporting

confidence: 91%

Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial

Lee

Jang

et al. 2021

Toxins

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“…This pioneering study investigated the effect of intraglandular BoNT injection on hyperlacrimation. Subsequently, several case reports showed satisfactory results for BoNT treatment of hyperlacrimation with minimal and transitory adverse events [15,16,17,18,19,20,21]. In these studies, 1–5 U of Botox ® (Allergan, Inc., Irvine, CA, USA) or 20 U of Dysport ® (Ipsen Ltd, Berks, UK) were injected into the lacrimal glands.…”

Section: Aqueous Deficiency: Bont Reduces Lacrimal Gland Secretionmentioning

confidence: 99%

A Review of Periocular Botulinum Neurotoxin on the Tear Film Homeostasis and the Ocular Surface Change

Fang

Chang

et al. 2019

Toxins

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Clinical usage of botulinum neurotoxin (BoNT) in ophthalmology has dramatically increased since the 1980s and has become one of the most widely used agents for treating facial movement disorders, autonomic dysfunction and aesthetic wrinkles. Despite its high efficacy, there are some complications with periocular BoNT injections due to its chemodenervation effect. Among these, there is still controversy over the BoNT effect on tear film homeostasis and the ocular surface. A periocular BoNT injection could dry the eye by reducing tear production of the lacrimal gland and increase tear evaporation due to potential eyelid malposition and abnormal blinks. On the contrary, the injection of BoNT in the medial eyelids could treat dry eye disease by impairing lacrimal drainage. Regarding the ocular surface change, corneal astigmatism and high-order aberrations may decrease due to less eyelid tension. In conclusion, the entire awareness of the effect of BoNT and the patients’ ocular condition is crucial for successful and safe results.

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“…La réduction du battement des paupières le long de la surface oculaire par les injections régulières de NTB/A améliore l'OSDI [28]. Les injections trimestrielles de NTB/A dans les muscles orbiculaires améliorent les larmes dans le SS en quantité et en qualité [29] malgré une action inhibitrice de la NTB/A si elle était injectée dans la glande lacrymale principale [30]…”

Section: Discussion Et Conclusionunclassified

Blepharospasm, dry eye and extractable nuclear antigen antibodies

Girard

Abdellaoui

et al. 2020

Journal Français d'Ophtalmologie

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Botulinum neurotoxin A injection for the treatment of epiphora with patent lacrymal ducts

Cited by 23 publications

References 21 publications

Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial

Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial

A Review of Periocular Botulinum Neurotoxin on the Tear Film Homeostasis and the Ocular Surface Change

Blepharospasm, dry eye and extractable nuclear antigen antibodies

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