Observation Of Curative Effect Of Injection Of Botulinum Toxin A Into The Lower Eyelid In The Treatment Of Severe Dry Eye

Objective:In this study,botulinum toxin A was injected into the medial lower eyelid to treat severe dry eye disease.To evaluate the efficacy of local injection of botulinum toxin A in the treatment of severe dry eye disease,and introduce new options for the treatment of dry eye disease.Methods:70 patients with severe dry eye disease(DED)were enrolled from January,2018 to June,2018.In this prospective study,eyes were randomly assigned to Botulinum toxin A group(observation group)and saline group(control group).Before and at 2weeks,4 weeks,3 months and 6 months after injection,the OSDI,TMH,PRTT and SIt were assessed.Results:1.There was no significant difference in the index of OSDI between two groups of patients diagnosed with aqueous tear deficiency dry eye before injection(Z=-0.055,P>0.05).Nevertheless,OSDI was lower at 2 weeks,4 weeks and 3 months after injection in observation group(Z=-5.138,P<0.05.Z=-4.981,P<0.05.Z=-4.720,P<0.05).No significant difference was observed in OSDI at 6 months between 2groups(Z=-0.908,P>0.05).2.There was no significant difference in the index of OSDI between two groups of patients diagnosed with high evaporation dry eye before and at 2 weeks,4 weeks and3 months after injection(Z=-1.645,P>0.05.Z=-1.692,P>0.05.Z=-1.71,P>0.05.Z=-1.452,P>0.05.Z=-1.822,P>0.05).3.There was no significant difference in TMH between two groups in patients diagnosed with aqueous tear deficiency dry eye before injection(Z=-1.546,P>0.05).TMH was higher at 2 weeks,4 weeks and 3 months after injection in observation group(Z=-5.183,P<0.05.Z=-5.176,P<0.05.Z=-5.170,P<0.05).No significant difference was observed in TMH at 6 months between 2 groups(Z=-0.255,P>0.05).4.There was no significant difference in TMH between two groups in patients diagnosed with high evaporation dry eye before injection(Z=-0.092,P>0.05).TMH was higher at 2 weeks,4 weeks and 3 months after injection in observation group(Z=-5.169,P<0.05.Z=-5.175,P<0.05.Z=-5.172,P<0.05).No significant difference was observed in TMH at 6 months between 2 groups(Z=-1.665,P>0.05).5.There was no significant difference in PRTT between two groups in patients diagnosed with aqueous tear deficiency dry eye before injection(Z=-1.322,P>0.05).PRTT was longer at 2 weeks,4 weeks and 3 months after injection in observation group(Z=-5.170,P<0.05.Z=-5.174,P<0.05.Z=-5.180,P<0.05).No significant difference was observed in PRTT at 6 months between 2 groups(Z=-1.816,P>0.05).6.There was no significant difference in PRTT between two groups in patients diagnosed with high evaporation dry eye before injection(Z=-0.172,P>0.05).PRTT was longer at 2 weeks,4 weeks and 3 months after injection in observation group(Z=-5.173,P<0.05.Z=-4.602,P<0.05.Z=-5.171,P<0.05).No significant difference was observed in PRTT at 6 months between 2 groups(Z=-1.315,P>0.05).7.There was no significant difference in SIt between two groups of patients diagnosed with aqueous tear deficiency dry eye before and at 2 weeks,4 weeks and 3months after injection(Z=-1.000,P>0.05.Z=-0.784,P>0.05.Z=-0.479,P>0.05.Z=-0.859,P>0.05.Z=-0.380,P>0.05).8.There was no significant difference in SIt between two groups of patients diagnosed with high evaporation dry eye before and at 2 weeks,4 weeks and 3months after injection(Z=-1.000,P>0.05.Z=-1.516,P>0.05.Z=-1.29,P>0.05.Z=-1.645,P>0.05.Z=-1.215,P>0.05).Conclution:1.The injection of botulinum toxin A at the medial lower eyelid can temporarily improve the symptoms of severe patients diagnosed with aqueous tear deficiency dry eye.2.The injection of botulinum toxin A at the medial lower eyelid can temporarily reduce the volumn of tear discharge and increase tear retention.