Girard Brigitte, Carré Fabienne, Begnaud Simon
Ophthalmology Department, Tenon Hospital, AP-HP, 4 rue de la Chine, 75020 Paris, France.
Health Faculty Pitié-Salpétrière Site, Bd de l'Hôpital, Sorbonne University, 91-105, 75013 Paris, France.
Toxins (Basel). 2025 Jul 31;17(8):383. doi: 10.3390/toxins17080383.
While surgical procedure has been considered as the golden standard treatment for spasmodic entropion, Botulinum Neurotoxin A can be indicated in the treatment of spasmodic entropion for fragile elderly patients. This retrospective cohort study included 50 outdoor patients treated for spasmodic entropion, for whom palpebral surgery was recused. The intent of the present study was to describe an alternative outdoor treatment, to detail precisely the Botulinum Neurotoxin (BoNT) treatment pattern, the dosage of BoNT needed, the frequency of re-injection, the efficiency and the complications encountered. Fifty patients, 87.9 years old in average (±14.3) have been injected with BoNT. The average total dosage of BoNT is 7.62 ± 1.38 units of Incobotulinum, 10.2 ± 1.03 units of Onabotulinum and 17.2 ± 1.33 Speywood-units of Abobotulinum. Spasmodic entropion resolved in 3 ± 2 days after the BT injection. The average for re-injection is every 4.25 ± 1.30 months. By adjusting age and total dose, we have not been able to show any statistically significant relationship between time needed for re-injection and type of botulinum toxin A ( = 0.59). Patients with spasmodic entropion have responded significantly to BoNT injection. No systemic complications have been reported in this study. BoNT treatment is safe and effective for fragile elderly patients with spasmodic entropion and can be proposed instead of surgery or while waiting for their procedure.
虽然外科手术一直被视为痉挛性睑内翻的金标准治疗方法，但A型肉毒杆菌神经毒素可用于治疗身体虚弱的老年痉挛性睑内翻患者。这项回顾性队列研究纳入了50例接受痉挛性睑内翻治疗的门诊患者，这些患者均不适合进行眼睑手术。本研究的目的是描述一种替代的门诊治疗方法，精确详细地说明肉毒杆菌神经毒素（BoNT）的治疗模式、所需的BoNT剂量、再次注射的频率、疗效以及所遇到的并发症。50例患者平均年龄为87.9岁（±14.3岁），均接受了BoNT注射。BoNT的平均总剂量为：因卡肉毒杆菌7.62±1.38单位、奥布肉毒杆菌10.2±1.03单位、阿泊肉毒杆菌17.2±1.33斯皮伍德单位。注射BoNT后3±2天痉挛性睑内翻症状缓解。再次注射的平均间隔时间为每4.25±1.30个月。通过调整年龄和总剂量，我们未能显示再次注射所需时间与A型肉毒杆菌毒素类型之间存在任何统计学上的显著关系（P=0.59）。痉挛性睑内翻患者对BoNT注射有显著反应。本研究中未报告任何全身并发症。BoNT治疗对于身体虚弱的老年痉挛性睑内翻患者是安全有效的，可作为手术的替代方法或在等待手术期间使用。
