Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Perioküler Bölgeye Kozmetik Amaçlı Botulinum Nörotoksin-A Uygulamasının Kuru Göz Hastalığı ve Oküler Yüzey Konforu Üzerine Etkisi: Olgu Kontrol Çalışması
Effect of Cosmetic Botulinum Neurotoxin-A Application to the Periocular Area on Dry Eye Disease and Ocular Surface Discomfort: A Case Control Study
İrfan Botan GÜNEŞa
aKocaeli Sağlık ve Teknoloji Üniversitesi Medicalpark Kocaeli Hastanesi, Göz Hastalıkları Kliniği, Kocaeli, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(2):121-7
doi: 10.5336/ophthal.2024-101257
Article Language: TR
Full Text
ÖZET
 Amaç: Perioküler bölgeye botulinum nörotoksin-A (BoNT-A) uygulamasının oküler yüzey konforu ve fonksiyonel kuru göz test sonuçları üzerine etkisini araştırmak. Gereç ve Yöntemler: Çalışmaya Ağustos 2023- Ocak 2024 tarihleri arasında göz hastalıkları kliniğimizde kozmetik amaçlı BoNT-A enjeksiyonu yapılan 38 kuru göz hastasının 38 gözü ve kontrol grubu olarak kuru göz hastalığı olmayan 39 katılımcının 39 gözü dâhil edildi. Katılımcıların BoNT-A enjeksiyonu öncesi ve enjeksiyon sonrası birinci ayda Schirmer testi, gözyaşı kırılma zamanı (GKZ), Oküler Yüzey Hastalık İndeksi [Ocular Surface Disease Index (OSDI®)] skoru ve en iyi düzeltilmiş görme keskinliği değerleri kaydedilerek grupların kendi içerisinde karşılaştırıldı. Bulgular: Ortalama Schirmer testi sonucu enjeksiyon öncesi ve enjeksiyon sonrası birinci ayda kuru göz grubunda sırasıyla 6,89±1,66 mm ve 5,60±1,25 mm; kontrol grubunda ise sırasıyla 22,00±7,18 mm ve 20,77±6,15 mm olarak ölçüldü. Schirmer değerinin iki grupta da enjeksiyon sonrasında anlamlı düzeyde azaldığı saptandı (sırasıyla p<0,001, p=0,003). Ortalama GKZ değeri enjeksiyon öncesi ve enjeksiyon sonrasında kuru göz grubunda sırasıyla 8,46±2,51 sn ve 7,35±1,83 sn, kontrol grubunda ise sırasıyla 14,55±3,57 sn ve 13,77±3,69 sn olarak saptandı. GKZ iki grupta da enjeksiyon öncesine göre anlamlı düzeyde düşük saptandı (sırasıyla p=0,001, p=0,014). Kuru göz grubunda ortalama OSDI® skoru enjeksiyon sonrasında anlamlı düzeyde artarken kontrol grubunda anlamlı farklılık saptanmadı (sırasıyla p=0,006 p=0,701). Sonuç: Perioküler bölgeye yapılan BoNT-A enjeksiyonu özellikle kuru göz hastalarında oküler yüzey ile ilgili yakınmalarda artışa ve fonksiyonel kuru göz testlerinde kötüleşmeye neden olmaktadır. Kuru göz hastaları BoNT-A enjeksiyonu öncesi bu konuda bilgilendirilmeli ve gerekli durumlarda kuru göz hastalığı tedavi planı gözden geçirilmelidir.

Anahtar Kelimeler: Botulinum toksinler, A tipi; kozmetikler; kuru göz sendromları; görme keskinliği
ABSTRACT
 Objective: To investigate the effect of botulinum neurotoxinA (BoNT-A) application to the periocular region on ocular surface discomfort and functional dry eye test results. Material and Methods: The study included 38 eyes of 38 dry eye patients who received BoNT-A injection for cosmetic purposes in our ophthalmology clinic between August 2023 and January 2024, and 39 eyes of 39 participants without dry eye disease as a control group. Schirmer test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI®) score and best corrected visual acuity values of participants before BoNT-A injection and in first month after the injection were recorded and compared within groups. Results: The mean result of the Schirmer test was 6.89±1.66 mm in dry eye group before injection and 5.60±1.25 mm in first month after injection. In control group it was 22.00±7.18 mm and 20.77±6.15 mm respectively. It was found that Schirmer value decreased significantly in both groups after injection (p<0.001, p=0.003 respectively). Mean TBUT before and after injection was 8.46±2.51 seconds and 7.35±1.83 seconds in dry eye group and 14.55±3.57 seconds and 13.77±3.69 seconds in control group respectively. It was found that TBUT was significantly lower in both groups than before injection (p=0.001, p=0.014 respectively). While mean OSDI® score increased significantly after injection in dry eye group, no significant difference was found in control group (p=0.006, p=0.701 respectively). Conclusion: Injection of BoNT-A into periocular area leads to an increase in ocular surface discomfort and worsening of dry eye functional tests, especially in patients with dry eye. Patients with dry eye should be informed of this prior to BoNT-A injection and the treatment plan for dry eye disease should be reviewed as necessary.

Keywords: Botulinum toxins, type A; cosmetics; dry eye syndromes; visual acuity
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