Tear Meniscus, Corneal Topographic and Aberrometric Changes After Botulinum Toxin-A Injection in Patients With Blepharospasm and Hemifacial Spasm

Abstract Purpose: To investigate the effect of Botulinum neurotoxin-A (BTX-A) treatment on dry eye symptoms, tear meniscus, corneal topography and corneal aberrometry in patients with benign essential blepharospasm (BEB) and hemifacial spasm (HFS).Materials and Methods: This prospective study comprised of 32 eyes from 8 BEB and 24 HFS patients. Tear meniscus height (TMH) and depth (TMD), tear break-up time (TBUT), corneal fluorescein staining score (CFSS), Schirmer I test, ocular surface disease index (OSDI) score, corneal topography [corneal power of flat axis (K1), corneal power of steep axis (K2), mean corneal power (Km), astigmatism and thinnest pachymetry] and anterior corneal aberrometry [spherical aberration (SA), vertical coma (vcoma), horizontal coma (hcoma), higher order root mean square (hRMS) and total RMS] were evaluated before BTX-A treatment and 3 weeks after BTX-A treatment.Results: 3 weeks after BTX-A injection TMH (265.9±116.4 µm vs. 347.1 ± 172.6 µm; p < 0.001) and TMD (178.1 ± 57.7 µm vs. 221.4 ± 90.3 µm; p < 0.001) showed a significant increase. TBUT, CFSS, Schirmer I test values were similar (p > 0.005). OSDI scores decreased significantly from 27.8 ± 26.1 to 18.4 ± 19.8 (p = 0.04). K2 (44.1 ± 1.7 D vs. 43.9 ± 1.7 D p = 0.009), Km (43.7 ± 1.6 D vs. 43.6 ± 1.6 D p = 0.025) and astigmatism (0.9 ± 0.6 D vs. 0.7 ± 0.5 D; p = 0.02) values improved significantly at 3 weeks. Pachymetry and aberrometric values did not change significantly.Conclusion: BTX-A injection increases tear meniscus and decrease symptoms related to dry eye disease in BEB and HFS patients. It decrease astigmatism and keratometry values but it does not cause a significant change in corneal aberrations.