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Imtiaz A Chaudhry, Farrukh A Shamsi, Yonca O Arat, Waleed A. Al-Rashed, Osama Al-Sheikh, Milton Boniuk; Botulinum toxin injection in the palpebral lacrimal gland for the management of epiphora. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4751.
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To report our experience with Botulinum toxin injections into the palpebral lacrimal gland through transconjunctival approach in the management of epiphora due to different causes.
We reviewed our experience with transconjunctival Botulinum toxin injection (2.5 - 5 U) in the palpebral lacrimal galnd of 56 adult patients in the management of epiphora due to different causes. Some of the causes of epiphora in our patients included crockadile tears (gustatory) secondary to aberrant regeneration of the facial nerve after facial nerve palsy, epiphora despite patent functional nasolacrimal system, ideopathic hypersecretion, persistent partial epiphora despite successful lacrimal drainage sugery and reflex tearing due to different causes.
Fourty-eight (86%) of our patients reported improvement from the Botulinum injections into their palpebral lacrimal gland through transconjunctival approach in the form of significantly decreased symptoms of epiphora. Patients remained symtpoms free between 2 to 6 months (average 4.4 month) after Botumlinum injection. Complications were low and inlcuded subconjunctival hemorrhage at the site of injection in 6 patients and transient diplopia in 2 patients and ptosis in 2 patients. Both the transient diplopia and ptosis resolved in 1 to 3 weeks in all patients.
Use of a single Botulinum toxin injection into the palpebral lobe of the lacrimal galnd through transconjunctival approach may be a viable option in adult patients with epiphora due to differnet causes with relatively mninimal complications.
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