Transcutaneous Dysport Injection for Treatment of Upper Eyelid Retraction Associated with Thyroid Eye Disease

Purpose: To evaluate the safety and efficacy of transcutaneous injections of botulinum toxin type A (Dysport) in the treatment of upper lid retraction associated with thyroid eye disease (TED).Methods: A total of 25 eyes of 16 patients including 11 female and 5 male subjects with stable TED condition were enrolled into the study. Mean age was 35.7 years (21–55). A transcutaneous injection of 20U Dysport was administered into each eyelid at the central superior tarsal border, aiming at the levator aponeurosis and Muller muscle. All patients were followed regularly for 4 to 6 months. Any complications, such as ptosis, diplopia, pain, or lid ecchymosis were recorded.Results: All patients experienced considerable reduction of palpebral fissure height. The mean lowering of the lid was 4.24 mm standard deviation (SD) =2.005, 2 weeks after intervention, and the effect remained for a minimum period of 4 months. There were temporary complications such as ptosis, which occurred in 4 patients for 4 weeks.Conclusions...