Evaluation of the Disport injection for treatment lid retraction in thyroid Ophthalmopathy via sub-conjunctival Approach

lid retraction is the most common presenting sign of thyroid Ophthalmology, which can cause several ophthalmologic problems such as dry eye, redness, lacrimation, exposure keratitis, and corneal ulcer or blindness. In this study, we evaluated disport injection via sub-conjunctival for management of lid retraction. This study is a prospective, non comparative, interventional case series. The study enrolled 25 patients (38 lids) with lid retraction secondary to thyroid Ophthalmopathy. The disport was injected in sub-conjunctival space at the superior margin of the tarsal plate. One –third of the total dose (10 unite) was administrated in three points of the lid and if eyelid retraction recurs another dose of disport was injected. Patient followed up for 12 months. In this study 8 patients (10 lids) showed improvement with single injection for 12 months or more. Other cases need more than one injection. There was negative correlation between age and satisfactory outcome. So that young patients had the best response, but with increasing age, especially above 50 years, amount and duration of response have decreased. Furthermore, other factors such as sex, duration of the systemic thyroid disease and proptosis lid have no influences on drug effectiveness. Our study shows sub-conjunctival injection of disport provides an effective and safe treatment for eyelid retraction due to thyroid Ophthalmopathy.