AIM: To investigate the choice basis of orbital muscle excision and botulinum toxin A injection in the treatment of blepharospasm.

METHODS: This retrospective clinical analysis was involved 100 cases with idiopathic blepharospasm. According to the degree of blepharospasm, they were divided into 0-Ⅳ grade, and divided into two groups. Group A included 60 cases(Ⅰ～Ⅲ grade)treated with botulinum toxin A, and 40 cases(>Ⅲ～Ⅳgrade)in group B treated with orbital muscle excision during the period from March 2012 to May 2014 in our hospital. Patients were followed up 3 ～ 24mo.

RESULTS: In 60 cases of group A, After treatment, 57 patients were completely corrected with classified grade of 0, 2 patients residue spasm, but its grade was decreased significantly, and 1 case had no effect. Of 40 patients in group B were in grade>Ⅲ～Ⅳ, 25 patients were poor response to botulinum toxin treatment and accompanied with drooping eyebrow and eyelid ptosis symptoms. Thirty patients were completely corrected after injection, 7 residue cases were in grade Ⅰ, 3 cases in grade Ⅱ.

CONCLUSION: The correct choice of the treatment for blepharospasm according to the clinical classification can improve the efficacy and safety.