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KMID : 1191420140130020046
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Korean Journal of Optometry and Vision Science
2014 Volume.13 No. 2 p.46 ~ p.52
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Treatment of Superior Limbic Keratoconjunctivitis Using Botulinum Toxin A
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Chun Yeoun-Sook
Kim Jae-Chan
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Abstract
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Purpose: To evaluate the changes of clinical symptoms and vital stainings before and after injection of botulinum toxin A into Riolan’s muscle in the treatment of patients with superior limbic keratoconjunctivitis (SLK).
Methods: Ten eyes of 5 patients diagnosed with SLK were injected with botulinum toxin A into the pretarsal orbicularis muscle, or Riolan’s muscle. The changes of clinical symptoms and stainings with fluorescein and rose bengal were evaluated on the day of diagnosis and at 1 week, 2 weeks, 4 weeks, and then monthly 6 months after the injection.
Results: The mean age was 46.8 years. Four patients were female and 1 was male. Dry eye syndrome and horizontal conjunctival corrugation were found in all 5 patients, superior conjunctivochalasis in 3 patients, and floppy eye lid syndrome in 1 patient. All five patients showed distinct improvement in clinical symptoms within 1 week after the injection. Improvement of vital stainings was observed at 2 weeks after the injection, and its effect maintained for 4.0 months (2-6 months). There was no ptosis associated with botulinum toxin injection.
Conclusions: Injection of botulinum toxin into Riolan’s muscle, which maintains lid tone, resolved symptoms and signs associated with SLK very effectively and rapidly.
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KEYWORD
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Blink related microtrauma, Botulinum toxin A, Riolan muscle, Superior limbic keratoconjunctivitis
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