Lacrimal gland botulinum toxin injection for epiphora management

ABSTRACT

Purpose

Epiphora remains an often difficult to manage ocular complaint for ophthalmologists in all subspecialties. This review seeks to examine the safety and efficacy of botulinum toxin injection for management of chronic epiphora.

Methods

The authors conducted a Pubmed search for studies on the use of lacrimal and transplanted salivary gland botulinum toxin injections for the management of epiphora within the past 20 years. Studies included had a minimum of four glandular injections.

Results

The authors identified 14 studies and divided them by indication for injection; either functional epiphora, non-functional epiphora, or mixed studies. Seven studies examined injections for cases of functional epiphora, four for non-functional epiphora, and four for mixed cases. The number of glandular injections reported ranged from 4 to 65. Side effects reported were limited to diplopia, eyelid or lacrimal gland hematoma, papillary conjunctivitis, dry eye, ptosis, and bleeding.

Conclusions

Glandular botulinum toxin injection should be considered as a viable treatment strategy for both functional and nonfunctional epiphora. From the studies reviewed, botulinum toxin injection was shown to be effective in both children and adults. Injection can be performed in the outpatient setting, is minimally invasive, technically easy to administer, has a favorable side effect profile, and good efficacy. Furthermore, repeat injections can be performed with similar efficacy.

KEYWORDS:

• Botulinum toxin injection
• epiphora management
• glandular botox injection
• lacrimal gland botox injection

Disclosure statement

Dr. Vinay Aakalu: In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that I am consultant to Horizon Pharmaceuticals. I have also received Grant Funding from the following:

1. Unrestricted Grant, Research to Prevent Blindness, NY,N

2. P30 EY001792 National Eye Institute, National Institutes of healt

I have disclosed those interests fully to Taylor & Francis, and I have in place an approved plan for managing any potential conflicts arising from this involvement.

Presentations

The content of this manuscript has not been presented or published elsewhere in any medium.