The Effect of Botulinum Toxin A Injection in the Upper Eyelid Retraction

ABSTRACT

PURPOSE: To investigate the effectiveness of botulinum toxin injections in the management of upper eyelid retraction associated with thyroid eye disease and developed after levator resection. METHODS: Under topical anesthesia, 2.5 to 7.5 units of botulinum toxin type A were administered medially and laterally at the superior margin of the tarsal plate after everting the upper eyelid. The level of the upper eyelid was evaluated by MRD1 obtained from photographs taken during the follow-up period. RESULTS: Of 9 patients treated, 5(55.6%) experienced some improvement in the amount of lid retraction after injections and 3(33.3%) showed good results with a difference in height between the two eyelids of less than 1mm. Ptosis was developed in two patients, but was transient and improved in one month. There were no other complications such as strabismus. CONCLUSIONS: This subconjunctival method of botulinum toxin injection is easy to administer and can be used safely and repeatedly, without significant side effects, for patients who do not wish to undergo a surgical procedure or as a temporary purpose before surgery.