Frueh B R, Musch D C
Ophthalmology. 1986 Jul;93(7):917-23. doi: 10.1016/s0161-6420(86)33641-8.
Forty-eight patients were given serial injections of botulinum toxin in their eyelids for treatment of eyelid spasm during a two-year interval. Ninety-four percent obtained relief of spasm from botulinum toxin injection. The duration of the spasm-free interval as well as the incidence of ptosis and of diplopia was dose dependent. The marked increase in the incidence of these side effects with only a small increase in the duration of the spasm-free interval, when a dose of 25 units per lid was used, leads the authors to conclude that this dose is too high and should not be used. Since diplopia was most commonly caused by paresis of the inferior oblique muscle, and since blepharospasm usually can be controlled by excising the upper lid protractors, further studies are required to determine whether lower lid injection is necessary and, if it is found to be so, whether injecting only the lateral portion of the lid would be adequate.
在两年的时间里，48名患者接受了肉毒杆菌毒素的系列眼睑注射以治疗眼睑痉挛。94%的患者通过肉毒杆菌毒素注射缓解了痉挛。无痉挛间隔的持续时间以及上睑下垂和复视的发生率与剂量相关。当每只眼睑使用25单位的剂量时，这些副作用的发生率显著增加，而无痉挛间隔的持续时间仅略有增加，这使得作者得出结论，该剂量过高，不应使用。由于复视最常见的原因是下斜肌麻痹，并且由于眼睑痉挛通常可以通过切除上睑牵开肌来控制，因此需要进一步研究以确定是否有必要进行下睑注射，如果有必要，仅注射眼睑外侧部分是否足够。
