Transcutaneous dysport injection for treatment of upper eyelid retraction associated with thyroid eye disease.
OBJECTIVE
To evaluate the safety and efficacy of transcutaneous injections of botulinum toxin type A (Dysport) in the treatment of upper lid retraction associated with thyroid eye disease (TED).


METHODS
A total of 25 eyes of 16 patients including 11 female and 5 male subjects with stable TED condition were enrolled into the study. Mean age was 35.7 years (21-55). A transcutaneous injection of 20U Dysport was administered into each eyelid at the central superior tarsal border, aiming at the levator aponeurosis and Muller muscle. All patients were followed regularly for 4 to 6 months. Any complications, such as ptosis, diplopia, pain, or lid ecchymosis were recorded.


RESULTS
All patients experienced considerable reduction of palpebral fissure height. The mean lowering of the lid was 4.24 mm standard deviation (SD) =2.005, 2 weeks after intervention, and the effect remained for a minimum period of 4 months. There were temporary complications such as ptosis, which occurred in 4 patients for 4 weeks.


CONCLUSIONS
A single transcutaneous injection of Dysport is safe and effective for treatment of lid retraction due to TED. Minor complications such as ptosis and diplopia may occur, however, this modality may offer temporary relief for patients with dysthyroid lid retraction awaiting orbital decompression or strabismus surgery or both.
Salour
Hossein
H
Shahid Beheshti University (MC), Shahid Tehran, Iran. hosalour@hotmail.com
Bagheri
Babak
B
Aletaha
Maryam
M
Babsharif
Babak
B
Kleshadi
Mandana
M
Abrishami
Mohammad
M
Bagheri
Abbas
A
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005141:Eyelid Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005143:Eyelids / Q000503:physiopathology; D005260:Female; D049970:Graves Ophthalmopathy / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000187:drug effects*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A