Dutton J J, Buckley E G
Duke University Eye Center, Durham, NC 27710.
Ophthalmology. 1988 Nov;95(11):1529-34. doi: 10.1016/s0161-6420(88)32977-5.
The authors review their long-term results and complications with the use of botulinum A toxin in the treatment of facial dystonias. Two hundred thirty-two patients in three diagnostic groups--essential blepharospasm, hemifacial spasm, and Meige's syndrome--were treated with botulinum A toxin. A total of 1044 treatments were given over a 4-year period. A reduction in orbicularis spasm intensity was noted in 1012 (96.9%) treatments (mean duration, 13.3 weeks). There was no clear relationship between toxin dose and the amount of spasm reduction or duration of response, and average duration of beneficial effect remained constant from the first through the twelfth injections. Complications occurred in 236 (22.6%) treatments. In most cases, these were local and transient. Symptomatic dry eye was the most common side effect, noted in 7.5% of cases. Ptosis was reported in 7.3% of treatments and photophobia in 2.5%. Diplopia involving the inferior oblique or lateral rectus muscles was seen in less than 1% of cases. There were no differences in degree of response or in complications among the three diagnostic groups, although there was a slight difference in duration of effect. Patients who had undergone previous eyelid surgery for blepharospasm did not respond differently from those without prior surgery.
作者回顾了使用A型肉毒杆菌毒素治疗面部肌张力障碍的长期结果及并发症。对三个诊断组的232例患者——特发性眼睑痉挛、半面痉挛和梅杰综合征——使用A型肉毒杆菌毒素进行治疗。在4年期间共进行了1044次治疗。1012次（96.9%）治疗中观察到眼轮匝肌痉挛强度降低（平均持续时间为13.3周）。毒素剂量与痉挛减轻程度或反应持续时间之间没有明显关系，从首次注射到第十二次注射，有益效果的平均持续时间保持不变。236次（22.6%）治疗出现并发症。在大多数情况下，这些并发症是局部的且为暂时性的。症状性干眼是最常见的副作用，见于7.5%的病例。7.3%的治疗报告有上睑下垂，2.5%有畏光。涉及下斜肌或外直肌的复视见于不到1%的病例。三个诊断组在反应程度或并发症方面没有差异，尽管在效果持续时间上有轻微差异。因眼睑痉挛此前接受过眼睑手术的患者与未接受过手术的患者反应没有不同。
