Study On The Effect Of Botulinum Toxin Type A On The Ocular Surface Status Of Patients With Idiopathic Blepharospasm

Objective:Based on the analysis of ocular surface function before and after periocular injection of Botulinum toxin type A(BTX-A)in patients with idiopathic blepharospasm,to explore the effect of periocular injection of Botulinum toxin type A on their ocular surface status.The patients were subjected to comprehensive ocular surface analysis and examination at 6time points,including Botulinum toxin type A periocular injection before,1week,2 weeks,3 weeks,4 weeks,and 12 weeks after injection.Methods:This is a prospective study.Thirty-two patients(39 eyes)who were diagnosed with idiopathic blepharospasm and received BTX-A eye injection from the Department of Ophthalmology of the First Affiliated Hospital of Hunan Normal University from August 2018 to December 2019 wereselected.The patients were subjected to comprehensive ocular surface analysis examination at 6 time points,including BTX-A periocular injection before,1 week,2 weeks,3 weeks,4 weeks,and 12 weeks after injection.Record Non-Invasive tear break up time first-time(NIBUTf),Non-Invasive tear break up time avg(NIBUTav),Tear Meniscus Height(TMH),Lipid layer thickness classification and meibomian gland losswere,these five indicators were used for statistical comparative analysis.Results:1.In this study,38 cases of idiopathic blepharospasm with dry eye syndrome were 16 eyes,and the prevalence rate was 42.1%.In patients with unilateral idiopathic blepharospasm who were not treated with BTX-A,the difference between NITBUTf and NITBUTav was statistically significant between the affected and healthy eyes(P<0.05);there was no significant difference in tear river height between the two groups(P>0.05);there is a statistically significant difference in the thickness of the lipid layer between the affected and healthy eyes(P<0.05),and there is no statistically significant difference between the affected and healthy eyes in terms of tear river height grouping and degree of meibomian gland loss(P>0.05).2.Tear break up time The differences in NITBUTf and NITBUTav at different times before and after BTX-A treatment were statistically significant(P<0.05).Except that there was no significant difference between NITBUTf before treatment and 1 week after treatment(P>0.05),there were statistically significant differences between the other time points(P<0.05).There was no significant difference between NITBUTav before treatment and the first and second weeks after treatment(P>0.05);there was no significant difference between the third and fourth weeks after treatment(P>0.05),and between the remaining time points,the differences between the two pairs was statistically significant(P<0.05).3.Tear Meniscus Height The differences in tear meniscus height at different times before and after BTX-A treatment were statistically significant(P<0.05).There were statistically significant difference between before treatment and 1 week after treatment,before treatment and 12 weeks after treatment(P<0.05);There were statistically significant difference between 2 weeks after treatment,4 weeks after treatment,and 12 weeks after treatment(P<0.05),and there was no significant difference between the other time points.4.Lipid layer thickness The differences in lipid layer thickness at different times before and after BTX-A treatment were statistically significant(P<0.05),and the differences were significant at different time points before and after treatment(P<0.05).There were statistically significant difference between 1 week after injection,2 weeks after injection and 3 weeks after injection and 4 weeks after injection(P<0.05).The difference was also statistically significant at 12 weeks after injection(P<0.05).There was no significant difference between 1 week,2 weeks,and3 weeks after treatment,and there was no significant difference between 4weeks and 12 weeks after treatment(P>0.05).5.Degree of meibomian gland loss There was no significant difference in the degree of meibomian gland loss at different times before and after BTX-A treatment(P>0.05).Conclusion:This study found that patients with idiopathic blepharospasm are prone to dry eye syndrome,the prevalence rate is 42.1%.Periocular Injection of botulinum toxin type A can prolong the tear break up time,improve the thickness of the lipid layer,and improve the ocular surface condition.