Effects of Chemodenervation on Ocular Synkinesis

Area of Science:

• Ophthalmology
• Neurology
• Plastic Surgery

Background:

• Chemodenervation is a common treatment for synkinesis in facial palsy patients.
• Objective data assessing the efficacy of chemodenervation for synkinesis is limited.
• Ocular synkinesis can significantly impact patients' quality of life.

Purpose of the Study:

• To objectively measure changes in eyelid palpebral fissure height after chemodenervation.
• To assess treatment effects at rest and during voluntary facial movement (puckering).
• To evaluate the impact of orbicularis oculi muscle chemodenervation on ocular synkinesis.

Main Methods:

• Retrospective review of patients treated for synkinesis between January 2015 and July 2023.
• Chemodenervation targeted the orbicularis oculi muscle.
• Computerized facial analysis (Emotrics+) measured palpebral fissure height from photographs at rest and during pucker.

Main Results:

• Palpebral fissure height increased by 1.16 mm at rest (p=0.014) and 2.31 mm during pucker (p<0.01).
• The mean follow-up period was 37.63 days post-injection.
• Injected dose did not correlate with changes in palpebral fissure height.

Conclusions:

• Chemodenervation of the orbicularis oculi muscle is effective in improving palpebral fissure height in ocular synkinesis.
• The treatment shows a greater effect during dynamic facial movements compared to the resting state.
• Objective photographic analysis provides valuable data for assessing synkinesis treatment outcomes.