Blepharoptosis

Photomed Laser Surg. 2008 Oct;26(5):507-9.

GaAs laser treatment of bilateral eyelid ptosis due to complication of botulinum toxin type A injection.

Majlesi G.

md_majlesi@yahoo.com

The widespread use of botulinum toxin type A (BTX-A) for aesthetic procedures in recent years has brought about some unwanted side effects that, though they are self-limited, cause inconvenience for patients. Injection of this paralytic toxin inactivates target muscle(s) for many months and unwanted facial movements will thus be prevented. Spreading of the toxin beyond the target muscles sometimes involves muscles necessary for other facial movements, such as the levator palpebrae, inactivation of which causes upper eyelid ptosis. Mild cases resolve after 2-3 wk, but in severe cases the complication may last as long as the cosmetic results persist (3-4 mo), and until now there has been no medical intervention to accelerate healing. In an effort to achieve more rapid recovery from eyelid ptosis due to overdose of BTX-A in the glabella, laser therapy was used in a 46-year-old woman with bilateral eyelid ptosis (partial on the right side and complete on the left) 12 d after injection. A GaAs laser was used and the protocol consisted of irradiation of three points on the upper lid just above the levator, and one point on the corrugator muscle on each side in contact mode, with three sessions per week (wavelength 890 nm, peak power 94 W, output power 28 mW, pulse duration 200 ns, spot size 3 mm, pulse repetition rate 3000 Hz, duration of irradiation 40 sec per point, energy per point 1.1 J, total energy per session 8.8 J, dose 16 J/cm2). The result was complete recovery from ptosis after 10 sessions, but the cosmetic results persisted for several months. It appears that if this procedure has similar results in other case series, it will be an effective therapeutic option to treat this complication.

Med Tekh. 2002 Nov-Dec;(6):14-6.

Combined treatment of congenital blepharoptosis in children and adolescents.

[Article in Russian]

Kokorev VIu, Riabtseva AA, Gerasimenko MIu, Filatova EV.

The paper deals with a complex procedure for rehabilitation of children with congenital blepharoptosis, which includes the multilevelled impact on the concerned central and peripheral links of the neuromuscular apparatus by using magnetic laser therapy and electrostimulation.