AIM: To compare the effects of different injection sites of type A botulinum toxin in the treatment of blepharospasm.

METHODS:Eighty-five patients(136 eyes)with blepharospasm treated in our hospital between June 2012 and June 2015 were selected as the study subjects and were divided into group A(43 cases, 66 eyes)and group B(42 cases, 70 eyes)by the random number table method. Both groups were treated with type A botulinum toxin injection. Complete injection model was adopted in group A while injection sites except lower eyelid was adopted in group B. The Jankovic rating scale(JRS)scores, blepharospasm disability index(BSDI), break-up time(BUT)and tear meniscus height(TMH)before treatment and at 3wk after treatment, incidence of side effects and recurrence rate in 90d of follow-up were compared between the two groups.

RESULTS: There were no significant differences in JRS score and BSDI between two groups before treatment(all P>0.05); 1 week after treatment, BUT and TMH increased in both groups. Three weeks after treatment, JRS scores and BSDI were lower than those before treatment(P<0.05)but there were no significant differences between groups(P>0.05). After treatment, there were no significant differences in JRS scores, BSDI and BUT between groups(P>0.05). TMH of group A was higher than that of groups B(P<0.05). Ninety days of follow-up showed that the recurrence rates in group A and group B were 14.0% and 11.9%, respectively, and the incidence rates of side effects were 23.3% and 16.7%, respectively(P>0.05).

CONCLUSION: Both of complete injection and injection sites except lower eyelid of botulinum toxin type A in the treatment of blepharospasm can effectively relieve symptoms and the effects on daily life. The 90 d recurrence rates are similar. Injection sites except lower eyelid can reduce the interference to the stability of tear film and lacrimal fluid drainage, with slight advantage.