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Chemodervation with abobotulinum toxin A (Dysport) and botulinum toxin type A (Botox) is finding an expanding role in functional and cosmetic cases. We describe the use of chemodenervation with abobotulinum toxin A for functional corneal protection in two cases and botulinum toxin type A for facial symmetry after Bell's palsy in one patient. The first case is a 75-year-old female with a nonhealing corneal erosion in her right eye secondary to epithelial basement membrane corneal dystrophy who underwent injection of 24 units of abobotulinum toxin A to the right Muller's muscle and levator palpebrae superioris to induce a protective ptosis. The second case is a 40-year-old male with corneal decompensation in the right eye after penetrating keratoplasty who underwent similar injection at both sites. The third case is a 46-year-old Asian female with history of Bell's palsty affecting her right side and causing mild left eyelid retraction who was injected 3 units of botulinum toxin type A to her Muller's muscle for lid positioning. Chemodenervation is used in these cases to purposefully induce ptosis by careful injection to Muller's muscle and the levator palpebrae superioris for functional and cosmetic purposes.

Although CNS vasculitis is well recognized as a post-streptococcal syndrome, this case illustrates that retinal vasculitis can also occur in this setting, and can resolve with oral steroid therapy.

Introduction: There has been little information reported on the use of fractionated CO2 laser resurfacing of the neck. We describe our initial experience with conservative treatment on the neck with concurrent treatment to the face. Materials and Methods: We retrospectively reviewed all cases of full-face and neck ablative fractionated CO2 laser resurfacing at our institution performed for the treatment of photodamage. Results: Eighteen consecutive patients were included with at least 3 months of follow-up. All neck settings were lower than the face settings. Eleven patients were treated with a 120μ spot size and 7 patients with a 300μ spot size. Average time of reepithelialization was 5 to 7 days for the full face and 7 to 14 days for the neck. Similarly for erythema resolution, patients reported an average of 4 weeks for improvement versus 6 weeks for the neck area. Two patients reported being dissatisfied with the procedure, and all others were happy with neck results. Complications included 1 case of herpes simplex virus reactivation with perioral lesions, 3 cases of postinflammatory hyperpigmentation of the face, and 1 case of postinflammatory hyperpigmentation with persistent erythema of the neck. Conclusions: Fractionated CO2 laser treatment to the neck involved delayed healing times despite the use of lower laser settings.

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