Okumus Seydi, Coskun Erol, Erbagci Ibrahim, Tatar M Gürkan, Comez Aysegul, Kaydu Erdal, Yayuspayi Ramazan, Gurler Bulent
Department of Ophthalmology, University of Gaziantep, Gaziantep, Turkey.
Clin Ophthalmol. 2012;6:579-83. doi: 10.2147/OPTH.S30277. Epub 2012 May 3.
The aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia.
Twenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases' severity of spasm (stage 0-4) and eyelid closing forces (stage 1-4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection.
Of the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52-65). Average onset of the Botox injection's effect was 2.8 ± 0.9 (2-5) days. Its effect lingered for about 11.5 ± 3.6 (8-22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P < 0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed.
Botox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.
本研究的目的是证明术前注射A型肉毒杆菌毒素（保妥适）对即将接受局部麻醉眼科手术的良性原发性睑痉挛患者的有效性。
本研究纳入了2004年1月至2011年5月期间在眼科手术前接受单侧保妥适注射的28例良性原发性睑痉挛患者。其中11例患有翼状胬肉，10例患有白内障，4例患有青光眼，其余3例患有无晶状体眼。在注射前、注射保妥适后3天、14天、1个月和3个月，根据扬科维奇量表对所有病例的痉挛严重程度（0 - 4期）和眼睑闭合力量（1 - 4期）进行评估。
本研究纳入的患者中，女性16例，男性12例，平均年龄55.52 ± 1.53岁（52 - 65岁）。保妥适注射效果的平均起效时间为2.8 ± 0.9（2 - 5）天。其效果持续约11.5 ± 3.6（8 - 22）周。对所有纳入患者在注射前、注射后3天和14天以及注射后第1个月和第3个月的痉挛严重程度和眼睑闭合力量进行比较。注射前与注射后3天（P = 0.001）、14天（P < 0.001）和1个月（P < 0.001）之间存在统计学显著差异。注射前与注射后3个月之间无统计学显著差异（P = 0.513）。注射后14天，手术成功进行。
眼科手术前注射保妥适可控制睑痉挛并降低手术前和手术期间可能遇到的风险，从而提高患者和外科医生的舒适度。
