Orbicularis Oculi Toxin Injection for Treating Levator Palpebrae Superioris Weakness: Clinical Effect and Safety in a Cohort Study

BACKGROUND: Ptosis, the drooping of the upper eyelid caused by levator palpebrae superioris muscle dysfunction, is a common condition that can impair vision and quality of life. It can arise independently or as a secondary condition to diseases such as myasthenia gravis. Traditional treatments for ptosis include surgical interventions, but botulinum toxin injections have gained interest due to their non-invasive nature and promising results in improving eyelid function. OBJECTIVES: To evaluate the efficacy and safety of orbicularis oculi muscle toxin injections in comparison to traditional levator palpebrae superioris muscle shortening surgery for the treatment of ptosis. METHODS: A cohort study was conducted with 36 patients diagnosed with levator palpebrae superioris muscle weakness. Patients were divided into two groups: an experimental group receiving botulinum toxin injections and a control group undergoing traditional surgery. Primary outcomes included changes in palpebral fissure height, visual scores, and patient satisfaction. Secondary outcomes involved adverse reactions and recovery time. RESULTS: The experimental group showed a significant improvement in palpebral fissure height (3.5 mm) and visual function compared to the control group (1.7 mm). Patient satisfaction was higher in the experimental group, particularly due to the non-invasive nature and shorter recovery period. The incidence of adverse reactions was lower in the experimental group, with fewer complications like scarring. CONCLUSIONS: Botulinum toxin injection may represent a minimally invasive alternative in carefully selected patients, particularly those with mild dysfunction or those wishing to avoid surgery. It provides significant improvements in palpebral fissure height and visual function, with fewer side effects and a faster recovery, making it a viable option for early-stage patients or those wishing to avoid surgery. Further studies should explore its long-term effectiveness.