J Korean Ophthalmol Soc.  2007 Oct;48(10):1318-1322. 10.3341/jkos.2007.48.10.1318.

Botulinum Toxin for Palliative Treatment of Epiphora in Patients with Nasolacrimal Duct Obstruction

• Lee JH
• Kim DY
• Kim KS

• KMID: 2210983
• DOI: http://doi.org/10.3341/jkos.2007.48.10.1318

Abstract

PURPOSE: To describe the use of botulinum toxin injection of the lacrimal gland for palliative treatment of epiphora secondary to nasolacrimal duct obstruction.
METHODS
A prospective non-comparative interventional case series study was designed to include 13 patients with nasolacrimal duct obstruction. Under topical anesthesia botulinum toxin A (1-4unit) was injected into the palpebral lobe of the lacrimal gland via a transconjunctival approach. Patients underwent a Schirmer test and a subjective evaluation of their epiphora symptoms was performed at 0 (baseline), 1, 4 and 12 weeks after injection.
RESULTS
Subjective epiphora scores improved in 10 out of the 13 patients (76.9%). Schirmer test results showed objective reduction in tearing from baseline but did not strongly correlate with the subjective epiphora scores. Transient ptosis were experienced by two patients.
CONCLUSIONS
Botulinum A toxin injection for palliative treatment of epiphora secondary to nasolacrimal duct obstruction is a simple, effective and safe treatment.

Keyword

Botulinum A toxin; Lacrimal gland; Nasolacrimal duct obstruction

MeSH Terms

Anesthesia
Botulinum Toxins*
Botulinum Toxins, Type A
Humans
Lacrimal Apparatus
Lacrimal Apparatus Diseases*
Nasolacrimal Duct*
Palliative Care*
Prospective Studies
Botulinum Toxins
Botulinum Toxins, Type A

Figure

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  Figure 1. Exposure of the palpebral portion of the right lacrimal gland using a Desmarres retractor.

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  Figure 2. Right upper lid ptosis following botulinum A toxin injection

Reference

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