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Carlos Y. Chen, Angel Nava; Treatment of Lower Eyelid Epiblepharon by Injection of Botulinum Toxin A in Patients Under Two Years of Age. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1062.
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To provide clinical evidence of the usefulness of botulinum toxin type A (BTX) effect when applied in patients with lower eyelid epiblepharon.
Prospective, nonrandomized, nonblinded study. Patients with lower eyelid epiblepharon with corneal eyelashes contact were included. Symptoms related to epiblepharon were measured using an analog scale and for epiblepharon clinical evaluation, the scale proposed by Khwarg and Lee was used. This scale measures three clinical aspects: height of skin fold, the area of cornea touched by cilia and the area of corneal erosion. A single dose of 12.5 IU of BTX (Dysport ®) was directly injected into the medial pretarsal orbicularis muscle region in the lower eyelid. Patients were evaluated before and at 1, 4, 12 and 24 weeks after injection. Descriptive statistics were calculated and Wilcoxon Signed Rank Test, comparing the results previous to the injection of BTX and at 6 month, considering p < 0.05 statistically significant was employed. Each eye was analyzed separately.
Fourteen eyes of 7 patients were treated, five girls and two boys. Mean age was 8.4 months (4-14 months). The height of skin-fold, the area of cornea touched by cilia and the symptoms score improved after the first week of BTX injection and remained so until the end of study. (p<0.05). No major complications were noted. (figure 1. Shows left eyelid of a 4 month child a)pretreatment, b)at first and c) sixth month of follow up
The effect of a single injection of 12.5 units of BTX (Dysport ®) injected into the medial orbicularis muscle portion in lower eyelid epiblepharon patients successfully improves clinical signs and symptoms.
Instituto de Oftalmología "Fundación Conde de Valenciana" I.A.P., CC-013-2009
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