Department of Oculoplastic Surgery, Hankou Aier Eye Hospital, Wuhan 430000, China.
Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Biomed Res Int. 2021 Mar 18;2021:9514279. doi: 10.1155/2021/9514279. eCollection 2021.
To observe the clinical efficacy of periocular injection of triamcinolone acetonide (TA) and subpalpebral injection of botulinum toxin type A (BTXA) for the treatment of thyroid-associated ophthalmopathy (TAO) with mild unilateral upper eyelid retraction.
This was a prospective randomized controlled study. A total of 68 cases of stable thyroid-associated ophthalmopathy with mild upper eyelid retraction were collected at Hankou Aier Eye Hospital from Jan. 2015 to Dec. 2018 and randomly divided into two groups. Group A contained 33 patients who were administered TA by periocular injection once every 3 weeks for a total of 3 times. Group B contained 35 patients who were given a single subpalpebral administration of BTXA. The efficacy in the two groups was observed.
Compared with the two groups, the effective rate in both groups was 100% at 1 week and 1 month after treatment. The effective rate of Group A remained 100% at 3 months after treatment, and that of Group B decreased to 88.6%. At 1 week after treatment, the degree of correction in Group B was greater than that in Group A ( < 0.001). At 1 month after treatment, it was not significantly different between the two groups ( > >>0.05). At 3 months after treatment, it was less in Group B than in Group A ( < 0.001). In Group A, there was one case of transient amaurosis, two cases of periorbital hemorrhage and swelling, and one mild case of sunken eyes. In Group B, four cases experienced recurrence after 3 months.
Periocular injection of TA and subpalpebral injection of BTXA offer definite therapeutic efficacy for mild upper eyelid retraction associated with thyroid disease. The former has a long treatment period, large procedural risks, and stable efficacy. The latter is a simple procedure with a short treatment period but can easily recur.
观察曲安奈德（TA）眼周注射联合肉毒毒素 A（BTXA）下睑注射治疗甲状腺相关眼病（TAO）伴轻度单侧上睑退缩的临床疗效。
前瞻性随机对照研究。2015 年 1 月至 2018 年 12 月于武汉爱尔眼科医院收集稳定期甲状腺相关眼病伴轻度上睑退缩患者 68 例，随机分为两组，A 组 33 例，行 TA 眼周注射，每 3 周 1 次，共 3 次；B 组 35 例，行 BTXA 下睑注射。观察两组疗效。
两组治疗后 1 周及 1 个月有效率均为 100%，A 组治疗后 3 个月有效率仍为 100%，B 组下降至 88.6%。治疗后 1 周，B 组矫正程度大于 A 组（ < 0.001）；治疗后 1 个月，两组间差异无统计学意义（ > >>0.05）；治疗后 3 个月，B 组小于 A 组（ < 0.001）。A 组治疗后出现一过性失明 1 例，眶周出血、肿胀 2 例，轻度眼球凹陷 1 例；B 组治疗后 3 个月复发 4 例。
TA 眼周注射和 BTXA 下睑注射治疗甲状腺相关眼病伴轻度上睑退缩均有确切疗效，前者疗程长，操作风险大，但疗效稳定；后者操作简单，疗程短，但易复发。
