title: Ocular surface changes following botulinum toxin injection for strabismus.
abstract: BACKGROUND
  Botulinum toxin injection is widely used for many purposes, including neuromuscular diseases, movement disorders and strabismus.
  
  
  OBJECTIVE
  To evaluate and report the impact of botulinum toxin injection on ocular surface parameters in patients with strabismus.
  
  
  METHODS
  Twenty-six consecutive patients who underwent botulinum toxin A injection for ocular misalignment were recruited for this prospective study.
  
  
  METHODS
  Testing of ocular surface parameters including tear break-up time (BUT), lissamine green (LG) staining and Schirmer test (under topical anesthesia) was performed, and Ocular Surface Disease Index (OSDI) questionnaire scores were recorded before and at certain time points after injection (one week, two weeks, one month, three months and six months after botulinum toxin A injection). Two-way analysis of variance (ANOVA) with repeated measures, Friedman's test and Wilcoxon test were used for statistical analysis.
  
  
  RESULTS
  Twenty six patients (15 eso- and 11 exo-deviations) with a mean age of 32.46 ± 14.41 (17-65) years were recruited for the study. All injections were performed in one eye. The mean amount of deviation at near and distance reduced after injection. The change of BUT, LG staining and OSDI scores was found to be significant during follow-up in treated eyes (p = 0.001, p = 0.007 and p = 0.009, respectively) whereas the change was insignificant for the Schirmer test results (p = 0.266).
  
  
  CONCLUSIONS
  The ocular surface parameters appear to be altered by botulinum toxin injection in strabismic patients. Even though these effects seemed to be temporary, the findings of the present study support the notion of botulinum toxin effects on ocular surface parameters.
authors: Department of Ophthalmology, Hacettepe University Medical School , Ankara , Turkey.
authors: Hande
authors: H
authors: Taylan Sekeroglu
authors: Sibel
authors: S
authors: Kocabeyoglu
authors: Mehmet Cem
authors: MC
authors: Mocan
authors: Ersin
authors: E
authors: Muz
authors: Jale
authors: J
authors: Karakaya
authors: Murat
authors: M
authors: Irkec
authors: Ali Sefik
authors: AS
authors: Sanac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000009:adverse effects* / Q000627:therapeutic use; D019573:Epithelium, Corneal / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013285:Strabismus / Q000188:drug therapy*; D013666:Tears; D055815:Young Adult
chemical_list: D019274:Botulinum Toxins, Type A
keywords: Botulinum; Schirmer test; break up time; dry eye; lissamine green; strabismus