Efficacy of a single subconjunctival injection with disport for lid retraction treatment

摘要

Objective: To evaluate the safety and efficacy of dysport injection via a subconjunctival approach in the management of upper lid retraction at 3 months follow up. Methodology: It is a prospective, non comparative, interventional case series study. It enrolled 22 patients (34 lids) with upper scleral exposure mainly associated with thyroid eye disease who were referred to the ophthalmic department of Ahwaz Imam Khomeini Hospital. A single injection of botulinum toxin A (dysport) was injected into the subconjunctival space at the superior margin of the tarsal plate by conjunctival approach. Main outcome measurements included upper lid position in relation to the upper limbus, patient satisfaction and any complication in the period of the study. Results: All patients experienced some improvement in the amount of lid retraction after injection. The amount of lowering varied between patients and lasted at least 3 months. A lid repositioning acceptable to the patient was obtained in 19 patients (26 lids) one patient had ptosis lasting 3 weeks and one patient had transient diplopia lasting 4 weeks. Conclusion: Subconjuntval injection of dysport provides a safe and effective treatment for upper eyelid retraction associated with thyroid eye disease. It is easy to adminster and is well tolerated by patient with few minor and transient side effects, such as diplopia and ptosis.