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J.M. Yonker, M. Abowd, E.H. Black; Evaluation of Lacrimal Gland Injection With Botulinum Toxin for the Treatment of Epiphora Due to Primary Hypersecretion of the Lacrimal Gland . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1954.
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© ARVO (1962-2015); The Authors (2016-present)
To establish the efficacy and safety of botulinum toxin in the treatment of epiphora of unknown etiology
Four patients were diagnosed with symptomatic epiphora of unknown etiology. After receiving counseling on the side effects of botulinum toxin and treatment modality, one randomly selected eye of each patient was chosen for treatment. 2.5 mouse units of botulinum toxin type A was injected via a transconjunctival approach into the palpebral lobe of the lacrimal gland between the secretory orifices. Standardized questionnaires were used in the careful recording of subjective and objective tearing data as well as any local or systemic side effects. Objective tearing measurements were made with a Schirmer’s test. Data was collected at the initial, 1 week, 4 week, and 4 months follow–up periods.
All four patients experienced a decrease in both their subjective and objective tearing. Schirmer’s testing showed a significant decrease in tear production. Onset of effect was seen at the 1 week follow–up period. The duration of effect was still seen at the 4 month examination, although there was trend for regression to baseline tearing seen at that point. One patient experienced transient upper lid ptosis, but no other local or systemic side effects were seen.
The injection of botulinum toxin type A via the transconjunctival approach is an overall safe and effective treatment for primary lacrimal gland hypersecretion
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