Effects of Botulinum Toxin a Treatment on Ocular Surface in Patients with Entropion

Öz

OBJECTIVE: This study aims to investigate the effects of Botulinum toxin A (BTA) and surgical intervention on the ocular surface in patients with entropion. MATERIALS and METHODS: This is a prospective case-control study. The patients who have entropion (senile and spastic) are treated with BTA or surgical operation (Jones Procedure). Tear break up time (TBUT), ocular surface disease index (OSDI) score, Schirmer I test, and Oxford scale were analyzed at the outset and one and three months after the procedure. RESULTS: Fifty patients (23 males, 27 females; mean age 65.04 ± 6.97 years) participated in the study. Significant improvements were observed in TBUT, OSDI, Schirmer I, and Oxford scores after both BTA and surgery. No difference was found in TBUT between the first and third month. OSDI scores were significantly lower in the group at both time points (p=0.039, p=0.049). Schirmer I was higher in the surgery group at the third month (p=0.040), while the BTA group had lower Oxford scores at the first month (p=0.037), with no difference at the third month. CONCLUSION: BTA application is an effective and safe method to improve ocular surface parameters in the treatment of entropion. The fact that some of these effects are superior to the surgical method may cause BTA application to be preferred in patients with ocular surface disorders.

Anahtar Kelimeler

• Anterior segment
• botulinum toxin A
• entropion
• eyelid

Entropiyonlu Hastalarda Botulinum Toksin A Tedavisinin Oküler Yüzey Üzerindeki Etkileri

Öz

AMAÇ: Bu çalışmanın amacı entropiyonlu hastalarda Botulinum toksin A (BTA) ve cerrahi müdahalenin oküler yüzey üzerindeki etkilerini araştırmaktır. GEREÇ ve YÖNTEM: Çalışma prospektif ve vaka-kontrol tipindedir. BTA ve cerrahi (Jones Prosedürü) uygulanan entropionlu (senil ve spastik) hastalarda gözyaşı kırılma zamanı (TBUT), oküler yüzey hastalık indeksi (OSDI) skoru, Schirmer I testi, Oxford skalası başlangıçta ve işlemden bir ve üç ay sonra analiz edildi. BULGULAR: Elli hasta (23 erkek, 27 kadın; ortalama yaş 65,04±6,97 yıl) çalışmaya dahil edildi. Hem BTA hem de cerrahi sonrasında TBUT, OSDI, Schirmer I ve Oxford skalasında anlamlı iyileşmeler gözlendi. TBUT’de birinci ve üçüncü aylar arasında fark bulunmadı. OSDI skorları her iki zaman diliminde de BTA grubunda anlamlı olarak daha düşüktü (p=0,039, p=0,049). Schirmer I üçüncü ayda cerrahi grupta daha yüksekken (p=0,040), BTA grubunun Oxford skorları birinci ayda daha düşüktü (p=0,37), üçüncü ayda ise fark yoktu. SONUÇ: BTA uygulaması entropiyon tedavisinde oküler yüzey parametrelerini iyileştirmek için etkili ve güvenli bir yöntemdir. Bu etkilerin bazılarının cerrahi yönteme göre daha üstün olması oküler yüzey bozukluğu olan hastalarda BTA uygulamasının tercih edilmesine neden olabilir.

Anahtar Kelimeler

• Botilinum Toksin A
• Entropiyon
• Göz Kapağı
• Ön Segment

Kaynakça

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