Comparison of Two Botulinum Neurotoxin A Injection Patterns with or without the Medial Lower Eyelid in the Treatment of Blepharospasm

The aim of this study was to evaluate the efficacy of two botulinum toxin a (bont-a) injection patterns with or without the medial lower eyelid (mle) in treating benign essential blepharospasm (beb) and influencing lacrimal drainage. two different injection patterns of bont-a were randomly applied to 98 eyes of 49 beb patients: mle group received a full injection pattern of 5 sites and non-mle group received a mle waived injection pattern of 4 sites. tear breakup time (but),schirmer i test,lagophthalmos height,and lower lid tear meniscus height (tmh) were measured and jankovic rating scale (jrs) was surveyed before injection and at 1 week,1 month,and 3 months after injection. the symptom of beb was relieved in both groups as suggested by jrs scores at all time points after injection,and mle group came up with a better jrs score at 3 months. the increases of schirmer i test value and tmh in mle group were higher than those in non-mle group at 1 week after injection. this study shows that the mle-involved full injection pattern is a better choice for patients with beb. it has longer-lasting effects in relieving beb symptoms and better efficacy in reducing lacrimal drainage. clinical trials registration number is nct02327728. © 2016 hui yang et al.