Botulinum Neurotoxin A Injections in Spasmodic Entropion: A Clinical Retrospective Cohort Study

While surgical procedure has been considered as the golden standard treatment for spasmodic entropion, Botulinum Neurotoxin A can be indicated in the treatment of spasmodic entropion for fragile elderly patients. This retrospective cohort study included 50 outdoor patients treated for spasmodic entropion, for whom palpebral surgery was recused. The intent of the present study was to describe an alternative outdoor treatment, to detail precisely the Botulinum Neurotoxin (BoNT) treatment pattern, the dosage of BoNT needed, the frequency of re-injection, the efficiency and the complications encountered. Fifty patients, 87.9 years old in average (±14.3) have been injected with BoNT. The average total dosage of BoNT is 7.62 ± 1.38 units of Incobotulinum, 10.2 ± 1.03 units of Onabotulinum and 17.2 ± 1.33 Speywood-units of Abobotulinum. Spasmodic entropion resolved in 3 ± 2 days after the BT injection. The average for re-injection is every 4.25 ± 1.30 months. By adjusting age and total dose, we have not been able to show any statistically significant relationship between time needed for re-injection and type of botulinum toxin A (p = 0.59). Patients with spasmodic entropion have responded significantly to BoNT injection. No systemic complications have been reported in this study. BoNT treatment is safe and effective for fragile elderly patients with spasmodic entropion and can be proposed instead of surgery or while waiting for their procedure.