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Exploratory Prospective Randomized Controlled Study to Evaluate a Modified Botulinum Toxin Injection Pattern for
Robert J Contento1, Collin J Anderson2, Robert H Hill2
1Norton College of Medicine, Upstate University Hospital, Syracuse, USA.
Cureus
|February 4, 2025
Summary
A modified botulinum toxin (Botox) injection pattern for benign essential blepharospasm (BEB) shows promise for longer effect duration and better spasm control. This exploratory study suggests a potential alternative treatment approach for BEB patients.
Area of Science:
- Ophthalmology
- Neurology
- Medical Aesthetics
Background:
- Benign essential blepharospasm (BEB) is a neurological movement disorder characterized by involuntary muscle contractions around the eye.
- Botulinum toxin (Botox) injections are a common treatment for BEB, but optimal injection patterns are still being explored.
- Established pretarsal injection techniques aim to provide symptom relief, but variations may offer improved outcomes.
Purpose of the Study:
- To compare an established versus a modified pretarsal botulinum toxin (Botox) injection pattern for treating benign essential blepharospasm (BEB).
- To evaluate differences in duration of effect, spasm control effectiveness, and complication rates between the two injection patterns.
- To assess the feasibility of the modified pretarsal Botox injection technique in BEB patients.
Main Methods:
- An exploratory randomized controlled trial was conducted with 8 female patients diagnosed with BEB.
- Patients received either an established or modified pretarsal Botox injection pattern, with 50 or 60 units of onabotulinumtoxinA administered.
- Primary outcomes included duration of effect and spasm control, assessed via a 10-point Likert scale at baseline and three-month follow-up.
Main Results:
- The modified pattern trended towards a longer mean duration of effect (82.9 days vs. 63.8 days) and improved spasm control (7.38 vs. 6.63 on Likert scale).
- Spasm severity, pain during injection, and complication rates (dry eye, tearing, ptosis) were similar between the established and modified patterns.
- Statistical significance was not achieved due to the small sample size, highlighting the exploratory nature of the study.
Conclusions:
- The modified pretarsal botulinum toxin injection pattern shows potential as an effective alternative for BEB treatment.
- Observed trends suggest improved duration and effectiveness of spasm control without increased complications.
- Larger-scale research is warranted to validate these preliminary findings and confirm the efficacy of the modified injection technique.
