Clinical Trial: Determination of the Optimum Delivery Route for Botulinum Toxin A in Patients With Epiphora

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Determination of the Optimum Delivery Route for the Intraglandular Administration of Botulinum Toxin A in Patients With Refractory Epiphora

Brief Summary: Epiphora or excessive tearing is a significant disability for many affected patients diminishing their quality of life. There is a growing consensus that injection of Botulinum Toxin A (BTX-A) into the lacrimal gland provides relief in patients with hyperlacrimation secondary to aberrant regeneration of the 7th nerve, and limited evidence that it might help to reduce normal tear production in patients with epiphora from anatomic or functional outflow obstructions. BTX-A has been injected both transconjunctivally into the palpebral lobe of the lacrimal gland and transcutaneously into the orbital lobe. Both delivery routes have been successful in symptom relief with minimal complications. However, the effectiveness of transconjunctival versus transcutaneous injections has not been systematically compared. Also, whether the incidence of side effects is related to the dosage, concentration, or location of injection is unknown and has also not been systematically studied. The investigators plan to conduct a randomized clinical trial in patients with functional tearing comparing the transcutaneous delivery route of BTX-A to the transconjunctival delivery route (the most common route described in the literature). The investigators will also compare the side effect profile of each delivery route.

Detailed Summary:
Sponsor: Merbs, Shannath, M.D., Ph.D.

Current Primary Outcome: Comparison of 1-minute Schirmer's test with and without anesthesia between treatment groups at baseline and follow up [ Time Frame: 24 weeks ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Comparison of side effect between each treatment group [ Time Frame: 24 weeks ]
  • Comparison of average score on epiphora severity scale between groups of interest at baseline and follow-up [ Time Frame: 24 weeks ]


Original Secondary Outcome: Same as current

Information By: Merbs, Shannath, M.D., Ph.D.

Dates:
Date Received: January 21, 2011
Date Started: February 2011
Date Completion:
Last Updated: September 11, 2012
Last Verified: September 2012