To describe the author's experience with the use of botulinum toxin (Botox, Allergan Inc., Irvine, CA, U.S.A.) injection in the palpebral lobe of the lacrimal gland for symptomatic epiphora due to lacrimal obstruction or gustatory tearing.
This is a retrospective review of 46 patients treated by the author with botulinum toxin injection in the palpebral lobe of the lacrimal gland for symptomatic epiphora due to lacrimal obstruction or gustatory tearing from 2001 through 2008. All patients were injected with 2.5 units of botulinum toxin, and the patients' subjective responses were assessed 1 to 2 weeks later. If there was insufficient response, they were reinjected with an additional 2.5 units of botulinum toxin and re-evaluated in 1 to 2 weeks. The response to the treatment and complications were evaluated.
Overall, 74% of patients treated felt that tearing was mostly or completely improved. The only complication was temporary ptosis in 11% of the patients.
Botulinum toxin injection in the palpebral lobe of the lacrimal gland can be used effectively and safely for symptomatic epiphora due to lacrimal obstruction and gustatory tearing. Although the beneficial results are temporary, the patient satisfaction in selected patients is high.
Botulinum toxin injection into the palpebral lobe of the lacrimal gland is a viable treatment for selected patients with epiphora from lacrimal obstruction and gustatory tearing.
The Emory Clinic, Atlanta, Georgia, U.S.A.
Accepted for publication July 16, 2010.
Presented in part at the American Society of Ophthalmic Plastic and Reconstructive Surgery Fall Meeting, Atlanta, GA, U.S.A., November 9, 2008.
The author has no financial interest in the products or techniques discussed in this article.
Supported in part by an unrestricted grant from Research to Prevent Blindness.
Address correspondence and reprint requests to Ted Wojno, M.D., The Emory Clinic, 1365-B Clifton Road, Atlanta, GA 30322, U.S.A. E-mail: firstname.lastname@example.org