BOTULINUM TOXIN TYPE-A IN UPPER LID RETRACTION OF GRAVES OPHTHALMOPATHY

Botulinum toxin type A (BTTA) was injected in the upper lid of 6 patie nts to reduce palpebral retraction due to Graves' ophthalmopathy. Five unilateral and one bilateral (all female) cases constitute the presen t series. Injection of 2.5 to 7.5 units of BTTA in the affected lids p roduced ptosis of 2 to 3 mm in 5 patients. A bilateral case showed a p ositive but insufficient response by the third injection. An acceptabl e position of the affected eyelids was maintained for 1 to 8 months. T he drug-effect period varied in every patient, regardless of the dose injected, amount of retraction, or endocrine status (hyper, hypo, or e uthyroidism) at the moment of treatment. In 5 of 6 patients BTTA provi ded acceptable upper lid position without cosmetic discomfort. The ear ly results obtained encouraged the use of botulinum toxin in this enti ty.