Evaluation of efficacy and safety of Botulinum toxin injection in treatment of epiphora

Abstract

Purpose The aim of this study was to evaluate the efficacy and safety of Botulinum toxin injection in the palpebral lobe of the lacrimal gland for treatment of epiphora. Patients and methods A total of 20 patients with epiphora (crocodile tears syndrome, lower lid laxity, malposition of the lower lid, and obstruction of lacrimal drainage system in which lacrimal surgery was impossible) received intralacrimal gland injection of Botulinum toxin (2.5 IU/0.1 ml). Follow-up was performed on the first day, first week, first month, third month, and sixth month after injection to evaluate the efficacy, safety, and occurrence of any complications and to record the rate of recurrence. Results Cure was successfully achieved in 60% of the patients after the first injection and in 90% of patients after the second injection. There were 15% of recurrent cases after the first injection, and there were no recurrent cases after the second injection. Temporary ptosis occurred in 10% of this study group after the first injection and in 5% after the second injection. There was a highly significant decrease in Schirmer’s test and tear meniscus height among the study group regarding the pre-injection and follow-up values (P<0.01). In addition, there was a highly significant decrease in Munk scale and time of dye disappearance test among the study group regarding the pre-injection and follow-up values (P<0.01). Conclusion The injection of Botulinum toxin in the palpebral lobe of the lacrimal gland was effective and safe as a temporary measure to reduce excessive tearing until a more permanent measure can be taken.

Keywords

• botulinum toxin
• epiphora
• lacrimal gland
• munk scale