title: Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm : BTX improves dry eye in patients with BEB.
abstract: OBJECTIVE
  To evaluate the effects of botulinum toxin type A (BTX-A) treatment in patients with benign essential blepharospasm (BEB) by monitoring the ocular surface and ocular higher-order aberrations (HOAs) before and after treatment.
  
  
  METHODS
  The present study reports a prospective case series of 38 patients (76 eyes, 11 men and 27 women; mean age 66.8 ± 9.8 years) with BEB who underwent BTX-A treatment at Kokura Memorial Hospital between 2013 and 2014. Patients were evaluated for ophthalmoscopic findings, Schirmer I test, tear film break-up time (t-BUT), HOAs, fluctuation index (FI), stability index (SI) using a wavefront aberrometer, 15 subjective symptoms using the Dry Eye-Related Quality of Life Score (DEQS), and complications before and after the treatment.
  
  
  RESULTS
  After BTX-A treatment, the Schirmer I test score improved significantly from 5.9 ± 5.4 to 8.7 ± 6.1 mm and t-BUT recovered from 5.2 ± 1.7 to 7.3 ± 1.7 s. HOAs were classified into four patterns: stable (60.5 %), small fluctuation (14.5 %), sawtooth (17.1 %), and reverse sawtooth (7.9 %), and they significantly reduced after the treatment. Only FI (not SI) showed a marked reduction, and the DEQS significantly improved from 44.7 ± 21.6 to 37.6 ± 21.0 after the treatment (p < 0.05). There were no complications during the observations.
  
  
  CONCLUSIONS
  BTX-A is a treatment with a high potential to improve ocular surface disorders induced by BEB.
authors: Department of Ophthalmology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. y-isshik@hyo-med.ac.jp.|Department of Ophthalmology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan. y-isshik@hyo-med.ac.jp.
authors: Yoshihiko
authors: Y
authors: Isshiki
authors: Department of Ophthalmology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors: Hiroto
authors: H
authors: Ishikawa
authors: Department of Ophthalmology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors: Osamu
authors: O
authors: Mimura
mesh_terms: D000368:Aged; D001764:Blepharospasm / Q000150:complications / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003315:Cornea / Q000000981:diagnostic imaging*; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D013666:Tears / Q000378:metabolism*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Blepharospasms; Botulinum toxin; Dry eye; Ocular higher-order aberrations; Ocular surface