THE EFFECT OF BOTULINUM TOXIN TYPE A IN PATIENTS WITH ESSENTIAL BLEPHAROSPASM

Cilj istraživanja: Cilj ovog istraživanja bio je utvrditi učinak botulinum toksina tipa A i zadovoljstvo kod pacijenata s esencijalnim blefarospazmom. Ispitanici i metode: U ovo prospektivno eksperimentalno istraživanje uključeno je 12 ispitanika koji boluju od esencijalnog blefarospazma te im je primijenjena terapija injekcijama botulinum toksina tipa-A. Istraživanje se provodilo u Klinici za očne bolesti Kliničkog bolničkog centra Split u razdoblju od prosinca 2019. do lipnja 2021. godine. U studiju je uključeno 11 žena i 1 muškarac u dobi od 49 do 86 godina. Ispitanicima je prije te dva do tri tjedna nakon zahvata dana anketa u kojoj se pitanja odnose na kvalitetu života i uključuju poteškoće pri čitanju, vožnji, gledanju televizije, izvođenju svakodnevnih aktivnosti, šetanju i kupovini u dućanu. Također im je dana ljestvica „Jankovic Rating Scale“ u kojoj se pitanja odnose na ozbiljnost i učestalost simptoma. U terapiji se koristio botulinum toksin tipa- A (Botox) koji smo razrijedili s 4 ml fiziološke otopine, tako da je u inzulinskoj brizgalici s integriranom iglom, od jednog mililitra 25 jedinica lijeka. Svi pacijenti su dobili po 25 jedinica po strani, u pet točaka (5 jedinica po točki) subkutano i to na dva mjesta na gornjoj vjeđi, zatim u središnjem području m. orbicularis oculi na donjoj vjeđi te u dvije točke u lateralnom dijelu mišića. Rezultati: Ukupna razina poteškoća snižena je (3,0 (2,2-3,2) vs. 1,6 (0,6-1,8)), odnosno kvaliteta života je narasla nakon primjene botulinum toksina, te je ispitivanjem utvrđeno da je porast statistički značajan (P=0,003). Ozbiljnost simptoma nakon primjene botulinum toksina snižena je (3,5 (3,0-4,0) vs. 2,0(1,0-2,0), što znači da je došlo do smanjenja ozbiljnosti poteškoća, te je ispitivanjem utvrđeno postojanje statistički značajne razlike (P=0,003). Učestalost simptoma je nakon primjene botulinum toksina snižena (3,0 (3,0-3,0) vs. 1,0 (1,0-2,5)), te je ispitivanjem utvrđeno postojanje statistički značajne razlike (P=0,012). Zaključak: Iz rezultata ovog istraživanja možemo utvrditi da primjenom botulinum toksina tipa-A dolazi do povećanja kvalitete života, te da se ozbiljnost i učestalost simptoma statistički značajno smanjuju.Objectives: The aim of this study was to determine the effect of botulinum toxin type A and satisfaction in patients with essential blepharospasm. Subjects and methods: This prospective experimental study included 12 subjects suffering from essential blepharospasm who received therapy with botulinum toxin type-A injections. The research was conducted at the Department of Ophthalmology of University Medical Center Split between December 2019 and June 2021. The study included 11 women and 1 man aged 49 to 86 years. Respondents were given a survey before and two to three weeks after the procedure in which were questions related to quality of life including difficulties in reading, driving, watching television, doing everyday activities, walking and shopping in the store. They were also given a "Jankovic Rating Scale" with questions related to the severity and frequency of symptoms. Botulinum toxin type-A (Botox) was used in the therapy and was diluted with 4 ml of physiological solution, so that in an insulin syringe with an integrated needle, there are 25 units of the drug from one milliliter. All patients received 25 units per side, at five points (5 units per point) subcutaneously in two places on the upper eyelid, then in the central area of the m. orbicularis oculi on the lower eyelid and at two points in the lateral part of the muscle. Results: The overall level of difficulties was reduced (3,0 (2,2-3,2) vs. 1,6 (0,6-1,8)), meaning the quality of life increased after the application of botulinum toxin, and the study found that the increase was statistically significant (P = 0.003). The severity of symptoms after the application of botulinum toxin was reduced (3,5 (3,0-4,0) vs. 2,0(1,0-2,0), which means that there was a decrease in the severity of the difficulties, and the study found a statistically significant difference (P=0,003). The frequency of symptoms was reduced after botulinum toxin administration (3,0 (3,0-3,0) vs. 1,0 (1,0-2,5)), and the study revealed a statistically significant difference (P = 0.012). Conclusions: From the results of this study, we can determine that the use of botulinum toxin type-A increases the quality of life, and that the severity and frequency of symptoms are statistically significantly reduced