| Popis: |
Background: Botulinum toxin A is a pre-synaptic neurotoxin, clinically effective not only in focal dystonias, but also in oculomotor problems and in oculoplastic surgery. Patients and methods: Botulinum A has been used at the Eye Hospital Ljubljana since 1988 to treat essential blepharospasm, hemifacialspasm, some paralytic and concomitant strabismus forms in oculoplastic procedures. Standard toxin doses and injection techniques are applied with care to possible immunological mechanisms. Results: Botulinum A was used in 882 patients with blepharospasm, in 77 with hemifacial spasm, in 27 patients with oculomotor dysfunction (strabismus, thyroid ophthalmopathy). Its use in oculoplastics (entropion, therapeutic ptosis, cosmetics) was considered only in individual patients. Our patients were adults, 28-94 year old (avarage age 72 years), mostly women, with 1-23 toxin applications. Our success rate was 97 %, constant, avarage effect duration was 16.5 weeks, even longer effect of patientćs wellness. Complication rate was below 10 %, with mild, temporary side effects like pain at the injection site, ecchymosis, ptosis with or without diplopia, dry eye sensation. Conclusions: Therapeutic use of botulinum toxin A is expected to grow, its application is simple and safe. To keep it this way for the gratifying results, the treating physician is well advised to learn the toxin properties, the anatomy and function of theextraocular muscles, and facial structures, to develop the skills of appropriate toxin adminstration and patient selection. |
