Botulinum neurotoxin injection for the treatment of epiphora in nasolacrimal duct obstruction

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

doi:10.1016/j.jfo.2017.03.006

Cited by 17 publications

(11 citation statements)

References 14 publications

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“…BoNT/A injection is used even in epiphora with obstruction of lacrimal duct [18,19,20]. In our experience the efficacy of BoNT/A injection in the principal lacrimal gland in the treatment of lacrimal free epiphora is a little lower than in the treatment of obstructive epiphora [20] with 78% Schirmer decrease versus…”

mentioning

confidence: 76%

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

Girard

Piaton

Keller

et al. 2018

Journal Français d'Ophtalmologie

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Patients with intractable epiphora despite patent lacrimal ducts can be effectively treated with BoNT/A (IncobotulinumtoxinA) injection into the palpebral lobe of the lacrimal gland. Most of the patients (80%) were very satisfied with few side effects (hematoma, ptosis or mild diplopia lasting from 3 days to 3 weeks). More studies are needed to delineate which types of epiphora can be treated with BoNT A.

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mentioning

confidence: 76%

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

Girard

Piaton

Keller

et al. 2018

Journal Français d'Ophtalmologie

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“…In 2003, Whittaker et al [22] used BoNT (2.5 to 5 U) to treat patients with functional epiphora and found that 8/11 (72.7%) patients had subjective and objective improvement in epiphora severity. In response to Whittaker et al [22], some studies performed BoNT treatment (1.25 to 7.5 U) in patients with lacrimal outflow obstruction, including canalicular obstruction, punctal occlusion, and nasolacrimal duct obstruction, and reported an overall satisfaction rate of 70% [23,24,25,26,27,28]. Compared to conjunctivodacryocystorhinostomy (CDCR), a complete bypass of the lacrimal drainage system from inferior half of the caruncle to the middle nasal meatus, intraglandular BoNT (4 U) injection had superior accessibility, safety, reversibility, and technical simplicity [27].…”

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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“…[ 16 ] Regarding complications, transient upper eyelid ptosis was the most frequent reported side effect. [ 24 25 ] We also observed appearance of mild and transient ptosis in one case which resolved spontaneously within 2 weeks and mild dryness of eyes in two cases.…”

Section: Discussionmentioning

confidence: 60%

Transconjunctival botulinum toxin injection into the lacrimal gland in crocodile tears syndrome

Pattanayak¹,

Sharma

Samikhya

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To determine the efficacy and safety of botulinum toxin injection into the lacrimal gland as a symptomatic treatment of crocodile tear syndrome (CTS). Methods: Our study included six patients of unilateral gustatory hyper lacrimation following either an episode of facial paralysis or post trauma or any related surgery that posed a risk of damaging the facial nerve. Detailed history regarding previous trauma, duration of facial paralysis, previous significant surgery, and duration of steroid use following facial paralysis was noted. Schirmer’s test was done at baseline and 3 months follow-up. Patients’ consent was taken prior to treatment with botulinum toxin injection in the lacrimal gland. Repeat injection of 5 U botulinum toxin (type A) was administered into the lacrimal gland of all patients transconjunctivally within an interval of 1 week. All patients were followed up with Schirmer’s test at 6 weeks and 3 months. Any complications during treatment were recorded. Results: All six patients showed complete or partial disappearance of reflex lacrimation while chewing following botulinum injection measured by a significant reduction in Schirmer’s value. When comparing Schirmer test values before (27.8 ± 3.58 mm) and after (11.6 ± 2.28 mm) BTX-A injection, the differences observed ( P = 0.002) were statistically significant ( P < 0.05). Only two patients developed mild transitory ptosis. No other complications were noted Conclusion: Transconjunctival botulinum toxin injection into the lacrimal gland is an effective and safe method to decrease reflex lacrimation during eating or chewing in CTS or gustatory hyper-lacrimation syndrome.

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Botulinum neurotoxin injection for the treatment of epiphora in nasolacrimal duct obstruction

Cited by 17 publications

References 14 publications

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

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

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

Transconjunctival botulinum toxin injection into the lacrimal gland in crocodile tears syndrome

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