To compare intralesional and oral propranolol for treating periorbital and eyelid capillary hemangiomas

PURPOSE: A pilot randomized control trial to compare the efficacy and side effects of intralesional and oral propranolol in periorbital and eyelid capillary hemangiomas. METHODS: Twenty patients were prospectively randomized to two groups of ten each. Group 1 was initiated on oral propranolol 1 mg/kg/day titrated to final dose of 3 mg/kg/day over 1 week which was continued for 6 months and then tapered over 1 week; Group 2 received 3 doses of direct intralesional propranolol hydrochloride 1 mg/ml; 0.2 ml/cm 4–6 weeks apart. Hemangioma area and corneal astigmatism were measured. RESULTS: Within each group at 6 months there was a significant reduction in area (group 1: 83.48 ± 11.67%, P = 0.0019; group 2: 67.78 ± 21.71%, P = 0.0019) and improvement in astigmatism (pre, post: group 1: 2.98D @ 179.8°, 1.13D @ 179.8°, P = 0.0045; group 2: 1.62D @ 90.16°, 0.75D @ 179.9°, P = 0.0001). There was no difference in area reduction (P = 0.056), change in appearance (P = 0.085), ptosis (P = 0.23) and side effects (lethargy, poor feeding; P = 0.171) between the two groups. CONCLUSION: Efficacy and side effects with intralesional propranolol are comparable to oral propranolol for periorbital and eyelid lesions.