Horwath-Winter J, Bergloeff J, Floegel I, Haller-Schober E-M, Schmut O
Department of Ophthalmology, Auenbruggerplatz 4, A-8036 Graz, Austria.
Br J Ophthalmol. 2003 Jan;87(1):54-6. doi: 10.1136/bjo.87.1.54.
Many patients with essential blepharospasm also show dry eye signs and symptoms. Botulinum toxin A is an effective treatment for reducing spasms in these patients. In this investigation, the effect of botulinum toxin A injections on tear function and on the morphology of the ocular surface in patients suffering from blepharospasm in combination with a dry eye syndrome was investigated.
Botulinum toxin A injections were applied to 16 patients with blepharospasm. All patients complained of dry eye symptoms and had reduced tear break up time values. A subjective questionnaire and ocular examinations including tear break up time, Schirmer test without local anaesthesia, and rose bengal staining were evaluated before, 1 week, 1 month, and 3 months after injection. Impression cytology was performed before, 1 month, and 3 months after botulinum toxin A treatment.
Although all patients were relieved of blepharospasm after botulinum toxin injections, only three noticed an improvement in dry eye symptoms. Eight patients noticed no difference and five complained of worsening. Tear break up time was found to be increased 1 week and 1 month after injections. Schirmer test measurements were reduced up to 3 months. Rose bengal staining slightly increased 1 week after injections. Impression cytology showed no definite change in conjunctival cell morphology 1 month and 3 months after botulinum toxin A injections.
In the patients presented here suffering from blepharospasm and dry eye, botulinum toxin A injections were effective in relieving blepharospasm but were not successful in treating dry eye syndrome.
许多原发性睑痉挛患者也表现出干眼的体征和症状。A型肉毒杆菌毒素是减轻这些患者痉挛的有效治疗方法。在本研究中，研究了A型肉毒杆菌毒素注射对合并干眼综合征的睑痉挛患者泪液功能和眼表形态的影响。
对16例睑痉挛患者进行A型肉毒杆菌毒素注射。所有患者均主诉有干眼症状且泪膜破裂时间值降低。在注射前、注射后1周、1个月和3个月对主观问卷和眼部检查进行评估，眼部检查包括泪膜破裂时间、无局部麻醉的泪液分泌试验和孟加拉玫瑰红染色。在A型肉毒杆菌毒素治疗前、治疗后1个月和3个月进行印迹细胞学检查。
尽管所有患者在注射A型肉毒杆菌毒素后睑痉挛均得到缓解，但只有3例患者注意到干眼症状有所改善。8例患者未发现差异，5例患者主诉症状加重。发现注射后1周和1个月泪膜破裂时间增加。泪液分泌试验测量值在3个月内降低。注射后1周孟加拉玫瑰红染色略有增加。印迹细胞学检查显示，A型肉毒杆菌毒素注射后1个月和3个月结膜细胞形态无明显变化。
在此类合并睑痉挛和干眼的患者中，A型肉毒杆菌毒素注射可有效缓解睑痉挛，但对干眼综合征治疗无效。
