IP International Journal of Ocular Oncology and Oculoplasty


The use of Lacrimal Gland Botulinum Toxin injection for the treatment of Epiphora in canalicular blocks


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Author Details: Amit Sethi, Vani Puri

Volume : 3

Issue : 3

Online ISSN : 2581-5016

Print ISSN : 2581-5024

Article First Page : 199

Article End Page : 202


Abstract

Context: Canalicular blocks or stenosis lead to epiphora which affects the quality of life. The treatment is primarily surgical which however has a high rate of failure and patient dissatisfaction.
Aim: The aim of this study was to find out the effects of botulinum toxin injected in the lacrimal gland in patients with epiphora due to canalicular block.
Setting and Design: Department of Ophthalmology and a prospective non comparative interventional study was carried out.
Patients and Method: Patients with epiphora due to canalicular block were included in the study. Transconjunctival injection of Botulinum toxin was given in the palpebral lobe of lacrimal gland under local anaesthesia. Epiphora scoring was done with a Schirmer’s test and Munk’s scoring (subjective test) both indoors and outdoors at baseline and at 1,4,12 and 24 weeks. The mean score for symptoms was calculated.
Statistical Analysis used: The mean decrease in scores was compared by student t test.
Result: 12 patients were included in the study. Subjective epiphora scoring (Munk’s scoring) improved in 11 out of 12 patients (92%) at 24 weeks follow-up. Objective epiphora scoring (Schirmer’s test) also showed similar results and correlated well with Munk’s scoring. Mild ptosis and diplopia was seen in 3 patients.
Conclusion: The results of this study were favorable and botulinum toxin can be a good alternative to surgery in patients suffering from epiphora due to canalicular block with minimal side effects and optimal patient satisfaction.

Keywords
: Canalicular block, Epiphora, Botulinum toxin, Munk’s score, Schirmer test