Department of Ophthalmology, General Hospital Bjelovar, Ulica Antuna Mihanovića 8, 43000, Bjelovar, Croatia.
Department of Ophthalmology, University Hospital Centre Zagreb, Zagreb, Croatia.
Int Ophthalmol. 2023 Jul;43(7):2291-2299. doi: 10.1007/s10792-022-02625-7. Epub 2023 Jan 1.
To evaluate the effectiveness of incobotulinumtoxinA (Xeomin) in treating upper eyelid retraction in patients with Graves orbitopathy (GO) initially scheduled for surgery via two different application sites.
This is a comparative, prospective study, conducted at the Department of Ophthalmology, Medical School, University Hospital Centre Zagreb, EUGOGO site (EUropean Group On Graves' Orbitopathy) in Croatia from January 2020 till January of 2021 in accordance with national health headquarter recommendations. All patients were classified as inactive with marked eyelid retraction and randomly divided into groups according to application sites. Group A underwent transconjunctival application (18 eyes) and group B transcutaneous application (20 eyes) of incobotulinumtoxinA. The primary end point of this study was lowering the eyelid, to alleviate anterior eye segment symptoms and achieve acceptable aesthetic appearance until surgery becomes available.
There were no nonresponders and we found no statistically significant difference in the degree of lowering the eyelid between the two application sites. Following rules for avoiding spread of SARS-CoV-19, none of the patients included in this study were infected. Moreover, participants reported diminishing of anterior eye segment irritation and improved aesthetics.
Treatment of inactive GO patients with incobotulinumtoxinA for upper eyelid retraction is efficient and safe and can be used as an adjuvant treatment while patients wait for surgery, by alleviating symptoms and improving the level of aesthetic satisfaction without causing a threat to anterior eye segment and visual function. The study showed that effect of treatment was the same, whether we applied the toxin transconjunctivaly or transcutaneously.
评估依库珠单抗毒素（Xeomin）通过两种不同的应用部位治疗 Graves 眼病（GO）患者上睑退缩的有效性。
这是一项在克罗地亚萨格勒布大学医院中心眼科进行的比较性、前瞻性研究，该研究符合国家卫生总部的建议，于 2020 年 1 月至 2021 年 1 月在克罗地亚的 EUGOGO 站点（EUropean Group On Graves' Orbitopathy）进行。所有患者均被归类为活动期伴明显眼睑退缩，并根据应用部位随机分为两组。A 组接受依库珠单抗毒素经结膜下应用（18 只眼），B 组接受经皮应用（20 只眼）。本研究的主要终点是降低眼睑，以缓解前节症状并达到可接受的美容外观，直至手术可行。
无无应答者，我们发现两种应用部位之间降低眼睑的程度无统计学差异。根据避免 SARS-CoV-19 传播的规定，本研究中没有患者感染。此外，参与者报告前节刺激减轻和美观度改善。
对于患有上睑退缩的非活动期 GO 患者，依库珠单抗毒素治疗是有效且安全的，可以作为一种辅助治疗方法，在患者等待手术的同时缓解症状并提高美容满意度，而不会对前节和视觉功能造成威胁。研究表明，无论我们是经结膜还是经皮应用毒素，治疗效果都是相同的。
