Tratamiento de la epífora funcional con toxina botulínica tipo A frente a la tira tarsal en un ensayo aleatorizado |
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| Institution: | 1. Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España;2. Grupo de Investigación e Innovación Miguel Servet de Oftalmología (GIMSO), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España;3. Universidad de Zaragoza (UNIZAR), Zaragoza, España;1. Sección Vítreo-retina, Servicio de Oftalmología, Hospital Universitario de Burgos, Burgos, España;2. Unidad de Tumores intraoculares, Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, España;1. Servicio de Oftalmología, Hospital Universitario de Móstoles, Madrid, España;2. Servicio de Oftalmología Infantil, Hospital Universitario La Paz, Madrid, España;3. Servicio de Radiología, Hospital Universitario La Paz, Madrid, España;4. Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España;1. Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España;2. Neonatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España;1. Servicio de Oftalmología, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana;2. Departamento de Retina y Vítreo, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana;3. Servicio de Oftalmología Pediátrica y Estrabismo, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana;4. Servicio de Retina y Vítreo y Servicio de Oftalmología, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana;1. Servicio de Oftalmología, Fundación Hospital de Jove, Gijón, España;2. Servicio de Cirugía Plástica y Reparadora, Fundación Hospital de Jove, Gijón, España;3. Unidad de Genética, Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España |
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| Abstract: | ObjectiveTo compare the efficacy of botulinum toxin A (BoNTA) injection into the lacrimal gland versus lateral tarsal strip (LTS) for functional epiphora.Material and methodsRandomized clinical trial. Sequential, parallel, non-blinded study design. Patients aged 18 years or older with functional epiphora and a minimum score of 3 in Munk Scale (MS) were randomized to BoNTA or LTS group. Changes in MS, Schirmer test and quality of life were assessed at week 6 and during follow-up until week 30. The mean time without epiphora and the adverse events were recorded.ResultsThe final analysis included 25 patients, 12 (21 eyes) assigned to BoNTA (5 U/0.05 mL) and 13 (20 eyes) to LTS. At 6 weeks there was an improvement in the MS in BoNTA versus LTS group (?2.48 vs. ?1.55, P = .0152) and at 12 weeks (?2.68 vs. ?1.69, P = .0267). A significant decrease was noted in the Schirmer test at week 2, 12 and 30 with BoNTA. The quality of life improved after both interventions without statistical significance. The mean duration of effectiveness in BoNTA group was 26.2 weeks (range 7.7-36.6) and in LTS group was 24.8 weeks (range 6.7-37.6), P = .9368. The main adverse events were temporary eyelid ptosis in 25% (3/12) of the BoNTA group and surgical scar discomfort in 23% (3/13) of the LTS group, P = .722. No adverse events were classified as severe.ConclusionBoNTA injection into the lacrimal gland is a safe and effective treatment for functional epiphora, with a greater decrease in MS at 6 and 12 weeks compared with LTS. |
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| Keywords: | Functional epiphora Botulinum toxin-A Lateral tarsal strip Munk score |
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