Long Term Patient Experience with Tetracycline Injections for Festoons.

PURPOSE To evaluate the long-term patient experience with tetracycline injections for treatment of festoons. METHODS Charts of all patients undergoing tetracycline injection for treatment of lower eyelid festoons at the Cole Eye Institute, Cleveland Clinic between 2008 and 2018 were identified using billing records. Patients were invited to participate in a questionnaire based on the FACE-Q checklist, a previously validated questionnaire for studying cosmetic procedure outcomes. Data from the questionnaire were summarized with size, mean and frequency. RESULTS One hundred two patients who received tetracycline injection during the study period were identified and sixty-one responses were obtained. The average follow-up time after injection was 3.6 years. Of 61 respondents, 36 (59%) noted improvement in their festoons after treatment and 27/33 (82%) noted improvement occurred within two months of treatment. Overall, 40/60 respondents (67%) would consider repeating tetracycline treatment. The most common adverse effects included discomfort (18%), swelling (15%) and bruising (13%). There was no statistically significant difference in questionnaire responses between males and females, except males were more likely to consider repeat injection (92% vs. 58%, p = 0.005). CONCLUSIONS Tetracycline injection appears to improve festoons in a majority of patients with an acceptable side-effect profile, although more data are needed to determine the optimal dose and frequency and to identify possible rare and/or significant side-effects.