Botulinum toxin A-induced protective ptosis in corneal disease

Ophthalmology. 1988 Apr;95(4):473-80. doi: 10.1016/s0161-6420(88)33163-5.


Botulinum toxin A produces a temporary, flaccid ptosis when injected into the levator palpebrae superioris muscle. The resulting protective ptosis was used to aid healing in 21 cases of indolent ulceration, and, prophylactically, in 4 cases of neuroparalytic keratitis. Of the indolent ulcers, 90% healed completely. In all but one case, the cornea was covered completely by the lid and complete ptosis was produced in 75% of cases in an average of 3.6 days, lasting for 16 days on average before recovery began. Recovery of levator function was complete in 8.5 weeks on average. Superior rectus underaction was seen in 68% of cases but this recovered completely in all cases in an average of 6 weeks. Impression cytology showed a trend toward normal conjunctival morphology as healing progressed.

MeSH terms

  • Blepharoptosis / chemically induced*
  • Blepharoptosis / physiopathology
  • Botulinum Toxins / adverse effects
  • Botulinum Toxins / therapeutic use*
  • Corneal Transplantation
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / pathology
  • Corneal Ulcer / surgery
  • Diplopia / chemically induced
  • Eye / blood supply
  • Hemorrhage / chemically induced
  • Humans
  • Keratitis / drug therapy*
  • Keratitis / pathology
  • Oculomotor Muscles / drug effects
  • Oculomotor Muscles / physiopathology
  • Time Factors
  • Wound Healing


  • Botulinum Toxins