Evaluation of Ocular Wave Front Aberrations in Pacients With Facial Dystonia Treated With Botulinum Toxin

Abstract

Purpose: : To analyze the effect of botulinum toxin A treatment on ocular wave front aberrations of patients with facial dystonia.

Methods: : Patients with benign essential blepharospasm (EB) and hemi facial spasm (HS) in activity were included in this study. All patients were submitted to slit lamp examination and bilateral wave front analysis under pupillary dilatation using Alcon LADARvision wave front device. After that, the patients were treated with botulinum toxin A subcutaneous injections in the affected area performed by the same ophthalmologist. After one month, the wave front analysis was performed in the same way and by the same examiner. The main outcome measure was the change in ocular wave front aberrations. Statistical analysis: Paired T test was performed to compare pre and pos-injection values. A p value of <0.05 was set for statistical significance.

Results: : A total of 6 patients with BS (54.5%) and 5 with HS (45.5%) were included in the study. The contralateral eyes of patients with HS were excluded, totalizing 17 eyes with spasm. Eight patients were female (72.7%) and three were male (27.3%). The age ranged from 50 to 72 years with a mean of 65.9 ± 8.2 years. The mean of high order RMS wave front aberrations was 0.68 before the treatment and 0.63 one month after (p=0,011). Before the treatment, the mean of spherical aberration was 0.23 and 0.17 one month after the treatment (p=0.014). Before the treatment, the mean of defocus, astigmatism, coma and spherical aberration was respectively 2.66, 0.8 and 0.44. One month after treatment, the mean of defocus, astigmatism and coma was respectively 2.62, 0.77 and 0.45. There was no significant difference in these aberrations before and after the treatment (p>0.05).

Conclusions: : The treatment of facial dystonia with botulium toxin may be able to modify the cornea curvature and decrease spherical aberrations.

Keywords: eyelid • refractive surgery: other technologies • cornea: clinical science