ABSTRACT
PURPOSE: The aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia. MATERIALS AND METHODS: Twenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases' severity of spasm (stage 0-4) and eyelid closing forces (stage 1-4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection. RESULTS: Of the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52-65). Average onset of the Botox injection's effect was 2.8 ± 0.9 (2-5) days. Its effect lingered for about 11.5 ± 3.6 (8-22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P < 0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed. CONCLUSION: Botox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.
ABSTRACT
PURPOSE: To show the efficiency of repetitive probing performed with intranasal endoscopic imaging in cases who underwent unsuccessful probing and the accompanying nasal pathologies. METHODS: Eighty-four eyes of the 64 patients in whom primary probing was found to be unsuccessful were included in the study. Cases were divided into 3 groups, depending on the number of unsuccessful attempts (1 [group 1], 2 [group 2], and 3 [group 3] unsuccessful probings). Diagnosis of congenital nasolacrimal duct obstruction was confirmed by history taking, clinical examination, and fluorescence disappearance test. All cases underwent nasal endoscopic-assisted probing and were followed up on the first week, first month, and third month following the procedure. RESULTS: There were 50 eyes in group 1, 23 in group 2, and 11 in group 3. The causes of failure that were determined with endoscopy were as follows: functional insufficiency 8.3%, lower nasal concha tension 4.7%, thin membrane in Hasner valve 3.6%, thick membrane and fibrosis in the distal side of the duct 21.4%, probe progressed submucosally on the nasal wall 33.3%, different exit location in the nose 20.2%, nasal mucosa ballooning in the distal side of the duct 4.7%, mucocele 2.4%, and nasal polyposis 1.2%. The success rate in the groups was estimated as 86% in the first group, 69.5% in the second group, and 54.5% in the third group. CONCLUSIONS: Performing the repetitive probings via nasal endoscopy provided information about the location and the shape of the obstruction and the opportunity to approach, according to the cause of the failure.
