Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora

PURPOSE: The purpose of this study is to assess the outcomes of lacrimal gland injections of botulinum toxin A (BoNTA) for epiphora secondary to lacrimal drainage disorders and functional epiphora. METHODS: This was a retrospective interventional case series where cases were divided into functional...

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Main Authors: Swati Singh, Akshay Gopinathan Nair, Md Shahid Alam, Bipasha Mukherjee
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Oman Journal of Ophthalmology
Subjects:
Online Access:http://www.ojoonline.org/article.asp?issn=0974-620X;year=2019;volume=12;issue=2;spage=104;epage=107;aulast=Singh
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author Swati Singh
Akshay Gopinathan Nair
Md Shahid Alam
Bipasha Mukherjee
author_facet Swati Singh
Akshay Gopinathan Nair
Md Shahid Alam
Bipasha Mukherjee
author_sort Swati Singh
collection DOAJ
description PURPOSE: The purpose of this study is to assess the outcomes of lacrimal gland injections of botulinum toxin A (BoNTA) for epiphora secondary to lacrimal drainage disorders and functional epiphora. METHODS: This was a retrospective interventional case series where cases were divided into functional and nonfunctional epiphora. RESULTS: A total of 37 eyes of 31 patients were identified: 13 males and 18 females. The mean age was 52 years (median = 53, range 29–86). The functional epiphora group had seven patients (8 eyes), subcategorized into hypersecretion (5), crocodile tears (1), and post seventh nerve palsy (1). Obstructive group (nonfunctional) had 24 patients (29 eyes), subcategorized into proximal canalicular block (12), common canalicular block (6), punctal stenosis (3), posttraumatic nasolacrimal duct obstruction (1), and partial nasolacrimal duct obstruction (1). Median preinjection Munk scores were similar in both groups (Grade 4). At 1 month, the median Munk score improved to 1 and 2 in functional and nonfunctional groups, respectively, after receiving a median dose of 4 units of BoNTA. Median reduction in Munk score was 75% in functional group versus 50% in nonfunctional group (P = 0.07). No difference in terms of complications was noted (transient ptosis). CONCLUSIONS: Reduction in epiphora after lacrimal gland injection of botulinum toxin is seen in cases with functional epiphora as well as those with a physical obstruction in the lacrimal drainage pathway. While the symptomatic improvement was more in functional epiphora, the difference between the two groups was not statistically significant.
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spelling doaj.art-7e948338e20e4926b5d406809816edff2022-12-21T23:29:01ZengWolters Kluwer Medknow PublicationsOman Journal of Ophthalmology0974-620X2019-01-0112210410710.4103/ojo.OJO_52_2018Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphoraSwati SinghAkshay Gopinathan NairMd Shahid AlamBipasha MukherjeePURPOSE: The purpose of this study is to assess the outcomes of lacrimal gland injections of botulinum toxin A (BoNTA) for epiphora secondary to lacrimal drainage disorders and functional epiphora. METHODS: This was a retrospective interventional case series where cases were divided into functional and nonfunctional epiphora. RESULTS: A total of 37 eyes of 31 patients were identified: 13 males and 18 females. The mean age was 52 years (median = 53, range 29–86). The functional epiphora group had seven patients (8 eyes), subcategorized into hypersecretion (5), crocodile tears (1), and post seventh nerve palsy (1). Obstructive group (nonfunctional) had 24 patients (29 eyes), subcategorized into proximal canalicular block (12), common canalicular block (6), punctal stenosis (3), posttraumatic nasolacrimal duct obstruction (1), and partial nasolacrimal duct obstruction (1). Median preinjection Munk scores were similar in both groups (Grade 4). At 1 month, the median Munk score improved to 1 and 2 in functional and nonfunctional groups, respectively, after receiving a median dose of 4 units of BoNTA. Median reduction in Munk score was 75% in functional group versus 50% in nonfunctional group (P = 0.07). No difference in terms of complications was noted (transient ptosis). CONCLUSIONS: Reduction in epiphora after lacrimal gland injection of botulinum toxin is seen in cases with functional epiphora as well as those with a physical obstruction in the lacrimal drainage pathway. While the symptomatic improvement was more in functional epiphora, the difference between the two groups was not statistically significant.http://www.ojoonline.org/article.asp?issn=0974-620X;year=2019;volume=12;issue=2;spage=104;epage=107;aulast=SinghBOTOXbotulinum toxindacryocystorhinostomyepiphorafacial palsyfunctionallacrimal obstructionlacrimationwatering
spellingShingle Swati Singh
Akshay Gopinathan Nair
Md Shahid Alam
Bipasha Mukherjee
Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
Oman Journal of Ophthalmology
BOTOX
botulinum toxin
dacryocystorhinostomy
epiphora
facial palsy
functional
lacrimal obstruction
lacrimation
watering
title Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
title_full Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
title_fullStr Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
title_full_unstemmed Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
title_short Outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
title_sort outcomes of lacrimal gland injection of botulinum toxin in functional versus nonfunctional epiphora
topic BOTOX
botulinum toxin
dacryocystorhinostomy
epiphora
facial palsy
functional
lacrimal obstruction
lacrimation
watering
url http://www.ojoonline.org/article.asp?issn=0974-620X;year=2019;volume=12;issue=2;spage=104;epage=107;aulast=Singh
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AT mdshahidalam outcomesoflacrimalglandinjectionofbotulinumtoxininfunctionalversusnonfunctionalepiphora
AT bipashamukherjee outcomesoflacrimalglandinjectionofbotulinumtoxininfunctionalversusnonfunctionalepiphora