ArticleInternational ophthalmology2025
Management of functional epiphora with botulinum toxin: a injection after lacrimal surgery.
Article in International ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the efficacy of botulinum toxin-A (BoNTA) injection for treating functional epiphora after lacrimal surgery. MATERIALS AND
methodsPatients with persistent epiphora following anatomically successful 3-snip punctoplasty or external dacryocystorhinostomy (ex-DCR) received transconjunctival BoNTA injections into the lacrimal gland. Symptom severity and tear production were assessed using the Munk score, Schirmer I test, and Watery Eye Quality of Life (WeQoL) questionnaire at baseline, and at 1, 3 months, and final follow-up after injection. Outcomes were compared pre- and post-injection and between surgical subgroups.
resultsThe study included 41 eyes of 32 patients (20 ex-DCR, 21 punctoplasty). Mean follow-up was 26.06 ± 0.7 months. All outcome measures (Munk score, Schirmer I, and WeQoL) showed significant improvement after both the first and last BoNTA injections. Improvements at 1 and 3 months were similar. The ex-DCR group required fewer injections (2.75 ± 0.1 vs. 3.13 ± 0.12; p = 0.003) with longer intervals between treatments (6.1 ± 0.1 vs. 5.4 ± 2 months; p = 0.02). At the 3-month follow-up after final injections, all scores were significantly better in the ex-DCR group (p < 0.05 for most comparisons).
conclusionBoNTA injection is an effective short-term treatment for functional epiphora after lacrimal surgery, particularly with more durable results following ex-DCR compared to punctoplasty.
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