Hassan Hussien Mahaa, Abd El-Wahed Hassan Elham, El-Haddad Nermien Salah El-Dien Mohammed
Ophthalmology resident, Cairo, Egypt.
professor of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ther Adv Ophthalmol. 2020 Dec 28;12:2515841420979113. doi: 10.1177/2515841420979113. eCollection 2020 Jan-Dec.
The aim of this study was to compare between hyaluronic acid filler (HA) and botulinum toxin type A (BTX-A) in the treatment of thyroid upper eyelid retraction.
This was a prospective comparative study.
A total of 50 eyes with upper thyroid eyelid retraction were divided into 2 groups. Each group included 25 eyes, (a) hyaluronic acid filler (HA) group: received subconjunctival HA injection and (b) botulinum toxin (BTX-A) group: received subconjunctival botulinum toxin type A injection. Full ophthalmic examination and thyroid profile were done. Marginal reflex distance 1 (MRD1) and total palpebral fissure height (TPFH) were measured before and after injection weekly for 6 months.
There is no significant difference between the two groups regarding MRD1 till the 10th week of follow up, then it became significant from the 11th to 15th week with better results in HA filler group, then the difference between the two groups become highly significant from the 16th week afterward with better results for the HA filler over the BTX-A. With regard to TPFH, there were significant differences between the BTX-A group and the HA group with a better result in BTX-A group in the first 8 weeks. Then the difference became insignificant till the 18th week. Then the difference became significant from the 19th till the 24th week with a better result in HA group.
HA filler has better result in treating thyroid upper eyelid retraction than BTX-A due to its predictable controllable effect, also, due to the longer duration of action and fewer side effects.
本研究旨在比较透明质酸填充剂（HA）和A型肉毒杆菌毒素（BTX-A）治疗甲状腺相关性上睑退缩的效果。
这是一项前瞻性对照研究。
将50例甲状腺相关性上睑退缩患者的50只患眼分为2组，每组25只眼。（a）透明质酸填充剂（HA）组：行结膜下HA注射；（b）肉毒杆菌毒素（BTX-A）组：行结膜下A型肉毒杆菌毒素注射。进行全面的眼科检查和甲状腺功能检查。在注射前及注射后每周测量1次边缘反射距离1（MRD1）和睑裂总高度（TPFH），持续6个月。
随访至第10周，两组MRD1无显著差异；第11至15周差异有统计学意义，HA填充剂组效果更佳；此后第16周起两组差异高度显著，HA填充剂组效果优于BTX-A组。关于TPFH，BTX-A组和HA组在前8周有显著差异，BTX-A组效果更佳；至第18周差异无统计学意义；第19至24周差异有统计学意义，HA组效果更佳。
HA填充剂治疗甲状腺相关性上睑退缩的效果优于BTX-A，因其效果可预测、可控，作用持续时间长且副作用少。
