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F. Martinez, M. Morales, J. Foster, E. Castro-Camacho; Use of Botulinum Toxin-A in the Treatment of Lid Retraction Secondary to Graves Orbitopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5840.
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To standarize the dosis of botulinum toxin-A as an initial treatment in lid retraction secondary to Graves orbitopathy
Prospective, comparative, interventional case series. In two different groups of patients we injected 2 International Units (IU) of botulinum toxin-A (group I) in a 1 to 1 dilution, and 4 IU (group II) in the tarsal conjunctiva of the temporal upper lid and 1 IU in the nasal upper lid. We measure the margin reflex distance (MRD) (temporal, central and nasal) the follow up measurments was done on weeks number one, 6, 12 and 24. We compared both groups.
We recruited 20 patients, 10 in each group, 15 female patients, 5 male. In all the patients we found a significant disminishing in the lid retraction. of 1 mm for every IU of botlinu toxin. The are no systemic adverse events reported , and one (5%) case of ptosis (MRD 1= 2mm) that improved after two weeks.
The use of botulinum toxin-A as a treatment in Graves orbitopathy is a secure and effective temporal procedure, that maybe used before a blefaroplasty o decompresive surgery after lid retraction secondatry to Graves Ophthalmopathy.
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