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. 2023 Sep-Oct;79(5):584-589.
doi: 10.1016/j.mjafi.2021.09.007. Epub 2021 Nov 28.

Efficacy and safety of injection Botulinum toxin in canalicular obstruction due to trauma

Sonali Vinay Kumar  1 , Vinay Kumar  2 , Sanjay Mishra  3 , Alok Sati  4
Affiliations

Efficacy and safety of injection Botulinum toxin in canalicular obstruction due to trauma

Sonali Vinay Kumar et al. Med J Armed Forces India. 2023 Sep-Oct.

Abstract

Background: The treatment of epiphora has undergone tremendous change in the past, and minimally invasive techniques are being preferred over traditional surgical options. One of them is the use of Inj Botulinum toxin, but there are very few studies that have explored its role in treating post-traumatic epiphora. This study was undertaken to find out the safety and efficacy of injection Botulinum toxin in treating epiphora due to canalicular obstruction following trauma.

Methods: A longitudinal interventional study was done, and a total of 50 patients were recruited. All patients were subjected to Inj Botulinum toxin in the lacrimal gland (10 units). The study was done for a period of 6 months, and patients were followed up for a period of another 6 months. Changes in Munk score, Schirmer test, and tear meniscus height were considered the main outcome measures.

Results: In our study, there were 38 males and 12 females. The age of the patients varied from 24 yrs to 67 yrs. Inj Botulinum toxin was found to be effective in 80% (n = 40/50) of cases as they reported a reduction in watering from eyes after administration of this injection. The complication associated with this treatment was minimal in our study as four patients reported diplopia, whereas two patients developed Ptosis that resolved spontaneously within two months.

Conclusion: Inj Botulinum toxin was found to be effective in epiphora caused by canalicular obstruction due to trauma. This treatment should be considered as an alternative treatment modality as it often leads to satisfactory reduction in epiphora in patients with less complications compared to surgical intervention.

Keywords: Botulinum toxin; Canalicular obstruction; Epiphora.

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Conflict of interest statement

The authors have none to declare.

Figures

Fig. 1
Fig. 1
(a): Clinical photograph showing palpebral lobe of the lacrimal gland (black arrow). (b): Clinical photograph showing infiltration of Botulinum toxin in the lacrimal gland with a 30 G needle attached with insulin syringe (black arrow).
Fig. 2
Fig. 2
Traumatic causes of canalicular obstruction.
Fig. 3
Fig. 3
Clinical outcomes in our study.
Fig. 4
Fig. 4
Complications in our study.
See this image and copyright information in PMC

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