Safety of onabotulinum toxin a injection to the central upper eyelid and eyebrow regions.
OBJECTIVE
To evaluate the safety of onabotulinum toxin A injected into the central upper eyelid and eyebrow regions.


METHODS
The authors retrospectively reviewed the charts of all patients undergoing onabotulinum toxin A injection to the central upper eyelid and eyebrow between February, 2012, and November, 2012. Age, gender, indication, injection sites, number of central units, total number of units, and occurrence of adverse events were all recorded.


RESULTS
A total of 300 procedures on 88 patients were performed, in whom the central upper eyelid and/or central eyebrow was injected with onabotulinum toxin A. There were 68 female and 20 male patients. Average age was 68.7±13.3 years (range, 42-92 years). Indications for central eyelid/eyebrow treatment included blepharospasm (34 patients, 176 procedures), hemifacial spasm (21 patients, 40 procedures), facial nerve disorders (2 patients, 9 procedures), and facial rhytides/eyebrow ptosis (31 patients, 75 procedures). The amount of neurotoxin injected into the central eyelid and eyebrow ranged from 2 to 12.5 units per encounter. Complications included diplopia (4% of total encounters), lagophthalmos (1% of total encounters), blepharoptosis (1% of total encounters), and blurry vision (1% of total encounters). Minor local effects, including bruising, bleeding, pain, and mild swelling, were recorded in 3.3% of total encounters.


CONCLUSIONS
Placement of onabotulinum toxin A into the central upper eyelid and eyebrow is associated with a low rate of blepharoptosis. Central eyelid and eyebrow neurotoxin injection can be safely added to the regimen when treatment calls for chemodenervation of the central orbicularis oculi.
*Case Western Reserve University School of Medicine; and †Cole Eye Institute, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, U.S.A.
Lily
L
Huang
Bryan R
BR
Costin
Natta
N
Sakolsatayadorn
Julian D
JD
Perry
D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000188:drug therapy; D001764:Blepharospasm / Q000188:drug therapy; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D005138:Eyebrows / Q000187:drug effects*; D005141:Eyelid Diseases; D005143:Eyelids / Q000187:drug effects*; D005155:Facial Nerve Diseases / Q000188:drug therapy; D005260:Female; D019569:Hemifacial Spasm / Q000188:drug therapy; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A