Keratoconus progression is not inhibited by reducing eyelid muscular force with
            botulinum toxin A treatment: a randomized trial

Renesto, Adimara da Candelária; Osaki, Tammy H.; Osaki, Midori Hentona; Hirai, Flávio E.; Campos, Mauro

doi:10.5935/0004-2749.20170022

Cited by 2 publications

(1 citation statement)

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“…In patients with keratoconus, reducing the eyelid muscular force by protective ptosis did not prove to slow down disease progression. [ 46 ]…”

Section: Protective Ptosismentioning

confidence: 99%

Five decades of the use of botulinum toxin in ophthalmology

Leszczynska,

Nowicka,

Pillunat

et al. 2024

Indian Journal of Ophthalmology

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Botulinum toxin (BoNT) has been known for over 50 years. It has conquered many areas of medicine and has become indispensable in contemporary medicine. Now, BoNT is used to treat at least 26 conditions in six medical specialties. Although the use of BoNT began in strabology, it became the gold standard for many ophthalmologic pathologies. The present review of the literature focuses on the use of BoNT in ophthalmology and treatment of the following conditions: blepharospasm, facial hemispasm, facial palsy, spastic entropion, strabismus, endocrine orbitopathy, convergence spasm, and facial trauma. We conclude that nearly half a century of experience in utilizing BoNT in ophthalmology ensured a satisfactory level of effectiveness and safety for patients with many pathologies. Areas of future research include the application of BoNT in new selected indications, the development of the route of application without injections, and the development of long-acting BoNT forms for patients who require repeated long-term treatment.

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“…In patients with keratoconus, reducing the eyelid muscular force by protective ptosis did not prove to slow down disease progression. [ 46 ]…”

Section: Protective Ptosismentioning

confidence: 99%

Five decades of the use of botulinum toxin in ophthalmology

Leszczynska,

Nowicka,

Pillunat

et al. 2024

Indian Journal of Ophthalmology

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Keratoconus Natural Progression

et al. 2019

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Purpose: We set out to describe the natural history of keratoconus. We included untreated patients, and our key outcome measures were vision, refraction, and corneal curvature. Clinical Relevance: Keratoconus affects 86 in 100 000 people, causing visual loss due to increasing irregular corneal astigmatism, and the quality of life declines in patients. Interventions are used to stabilize the disease or improve vision, including corneal cross-linking (CXL) and grafting, but these carry risks. Detailed knowledge of the natural history of keratoconus is fundamental in making informed decisions on when their benefits outweigh these risks. Methods: We included prospective or retrospective studies of pediatric or adult patients who reported 1 or more of visual acuity, refraction, and corneal curvature measures: steep keratometry (K 2), mean keratometry (K mean), or maximum keratometry (K max), thinnest pachymetry, corneal transplantation rates, corneal scarring incidence, and patient-reported outcome measures (PROMs). Databases analyzed included Medline, Embase, CENTRAL, and CINAHL. Searches were carried out until October 2018. Bias assessment was carried out using the Joanna Briggs Institute model of evidence-based healthcare. Results: Our search yielded 3950 publication titles, of which 41 were included in our systematic review and 23 were incorporated into the meta-analysis. Younger patients and those with greater K max demonstrated more steepening of K max at 12 months. The meta-analysis for K max demonstrated a significant increase in K max of 0.7 diopters (D) at 12 months (95% confidence interval [CI], 0.31e1.14; P ¼ 0.003). Our meta-regression model predicted that patients had 0.8 D less K max steepening over 12 months for every 10-year increase in age (P ¼ 0.01). Patients were predicted to have 1 D greater K max steepening for every 5 D of greater baseline K max (P ¼ 0.003). At 12 months, there was a significant increase in the average K mean of 0.4 D (95% CI, 0.18e0.65; P ¼ 0.004). Conclusions: We report the first systematic review and meta-analysis of keratoconus natural history data including 11 529 eyes. Younger patients and those with K max steeper than 55 D at presentation have a significantly greater risk of progression of keratoconus. Closer follow-up and a lower threshold for cross-linking should be adopted in patients younger than 17 years and steeper than 55 D K max .

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Keratoconus progression is not inhibited by reducing eyelid muscular force with botulinum toxin A treatment: a randomized trial

Abstract: BTX-A inhibition of eyelid force generation did not result in detectable changes in corneal parameters in keratoconic patients during 18 months of follow-up.

Cited by 2 publications

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Five decades of the use of botulinum toxin in ophthalmology

Five decades of the use of botulinum toxin in ophthalmology

Keratoconus Natural Progression

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