Dintelmann T, Sold J, Grehn F
Augenklinik, Universität, Würzburg.
Ophthalmologe. 2005 Mar;102(3):247-50. doi: 10.1007/s00347-004-1091-4.
Upper lid retraction associated with thyroid eye disease may result in conjunctival and corneal exposure as well as in an esthetic problem. We evaluated the effect of botulinum toxin injections in order to lower the upper lid.
This prospective study included 19 eyes of 13 female patients presenting with scleral exposure aged 28-50 years. We injected 5-15 IE botulinum toxin A (Botox) transconjunctivally into the levator muscle. Lid position, negative side effects, and patient satisfaction were evaluated.
Lid retraction improved from 2.4 mm (+/-1.4 mm) prior to injection to 0.5 mm (+/-2.3 mm) 4 weeks after injection. In 11 of 19 eyes 4 weeks after injection and in 8 of 14 eyes 12 weeks after injection scleral exposure had resolved. Diplopia did not occur and tear production was not influenced. Two eyes had transient ptosis. Lid lag increased from 0.34 (+/-0.6 mm) to 0.84 mm (+/-0.9 mm). Of 13 patients, 8 were satisfied with the result.
Botulinum toxin A injection provides effective treatment especially in mild lid retraction and as a temporary solution for patients with unstable thyroid disease.
与甲状腺眼病相关的上睑退缩可能导致结膜和角膜暴露以及美学问题。我们评估了肉毒杆菌毒素注射降低上睑的效果。
这项前瞻性研究纳入了13名年龄在28至50岁之间、有巩膜暴露的女性患者的19只眼睛。我们经结膜向提上睑肌注射5 - 15国际单位的A型肉毒杆菌毒素（保妥适）。评估了眼睑位置、负面副作用和患者满意度。
上睑退缩从注射前的2.4毫米（±1.4毫米）改善至注射后4周时的0.5毫米（±2.3毫米）。注射后4周时，19只眼中的11只以及注射后12周时，14只眼中的8只巩膜暴露问题得到解决。未出现复视，泪液分泌也未受影响。有两只眼睛出现了短暂性上睑下垂。眼睑滞后从0.34（±0.6毫米）增加至0.84毫米（±0.9毫米）。13名患者中，8名对结果满意。
注射A型肉毒杆菌毒素提供了有效的治疗，尤其适用于轻度上睑退缩，并且作为甲状腺疾病不稳定患者的一种临时解决方案。
