Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm : BTX improves dry eye in patients with BEB.

Abstract

To evaluate the effects of botulinum toxin type A (BTX-A) treatment in patients with benign essential blepharospasm (BEB) by monitoring the ocular surface and ocular higher-order aberrations (HOAs) before and after treatment. The present study reports a prospective case series of 38 patients (76 eyes, 11 men and 27 women; mean age 66.8±9.8years) with BEB who underwent BTX-A treatment at Kokura Memorial Hospital between 2013 and 2014. Patients were evaluated for ophthalmoscopic findings, Schirmer I test, tear film break-up time (t-BUT), HOAs, fluctuation index (FI), stability index (SI) using a wavefront aberrometer, 15 subjective symptoms using the Dry Eye-Related Quality of Life Score (DEQS), and complications before and after the treatment. After BTX-A treatment, the Schirmer I test score improved significantly from 5.9±5.4 to 8.7±6.1mm and t-BUT recovered from 5.2±1.7 to 7.3±1.7s. HOAs were classified into four patterns: stable (60.5%), small fluctuation (14.5%), sawtooth (17.1%), and reverse sawtooth (7.9%), and they significantly reduced after the treatment. Only FI (not SI) showed a marked reduction, and the DEQS significantly improved from 44.7±21.6 to 37.6±21.0 after the treatment (p<0.05). There were no complications during the observations. BTX-A is a treatment with a high potential to improve ocular surface disorders induced by BEB.