{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T09:27:01Z","timestamp":1794302821268,"version":"4.9.0"},"reference-count":53,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["ajo.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.ajo.2026.09.016","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:43:00Z","timestamp":1789602180000},"page":"619-633","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Impact of Botulinum Toxin on Ocular Surface Parameters in Patients With Orbicularis Spasm: A Systematic Review and Meta-Analysis"],"prefix":"10.1016","volume":"292","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6267-7996","authenticated-orcid":false,"given":"DAVI MAR\u00c7OLA","family":"VEIGA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALEXANDRE YAMADA","family":"FUJIMURA J\u00daNIOR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LAURA","family":"GOLDFARB\u202f\u202fCYRINO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DANIELA CLARA COUTINHO da","family":"SILVA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KARINA DE OLIVEIRA","family":"CANECA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DILLAN CUNHA","family":"AMARAL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GUSTAVO ROSA","family":"GAMEIRO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-5768","authenticated-orcid":false,"given":"RICARDO NOGUERA","family":"LOUZADA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.ajo.2026.09.016_bib0001","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s11940-000-0037-7","article-title":"Blepharospasm and hemifacial spasm","volume":"2","author":"Boghen","year":"2000","journal-title":"Curr Treat Options Neurol"},{"issue":"11","key":"10.1016\/j.ajo.2026.09.016_bib0002","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.2374","article-title":"Blink index as a response predictor of blepharospasm to botulinum neurotoxin-A treatment","volume":"11","author":"Jang","year":"2021","journal-title":"Brain Behav"},{"issue":"1-2","key":"10.1016\/j.ajo.2026.09.016_bib0003","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.neurol.2020.03.022","article-title":"Botulinum toxin for benign essential blepharospasm: a systematic review and an algorithmic approach","volume":"177","author":"Rayess","year":"2021","journal-title":"Rev Neurol (Paris)"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0004","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/0002-9394(73)90665-X","article-title":"Complications in surgery for blepharospasm","volume":"75","author":"Dortzbach","year":"1973","journal-title":"Am J Ophthalmol"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0005","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/qjmed\/95.8.493","article-title":"Hemifacial spasm and involuntary facial movements","volume":"95","author":"Tan","year":"2002","journal-title":"QJM"},{"issue":"2","key":"10.1016\/j.ajo.2026.09.016_bib0006","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1179\/1743132814Y.0000000424","article-title":"The mechanism of hemifacial spasm: a new understanding of the offending artery","volume":"37","author":"Dou","year":"2015","journal-title":"Neurol Res"},{"issue":"6","key":"10.1016\/j.ajo.2026.09.016_bib0007","doi-asserted-by":"crossref","first-page":"789","DOI":"10.4103\/IJO.IJO_1030_23","article-title":"Five decades of the use of botulinum toxin in ophthalmology","volume":"72","author":"Leszczynska","year":"2024","journal-title":"Indian J Ophthalmol"},{"issue":"9","key":"10.1016\/j.ajo.2026.09.016_bib0008","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1002\/mus.880150909","article-title":"Treatment of hemifacial spasm with botulinum toxin","volume":"15","author":"Yoshimura","year":"1992","journal-title":"Muscle Nerve"},{"issue":"3","key":"10.1016\/j.ajo.2026.09.016_bib0009","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/WNO.0000000000001770","article-title":"Orbicularis oculi muscle immunohistochemical, metabolic, and morphometric differences in affected and nonaffected sides in hemifacial spasm vs healthy subjects","volume":"43","author":"Osaki","year":"2023","journal-title":"J Neuroophthalmol"},{"issue":"11","key":"10.1016\/j.ajo.2026.09.016_bib0010","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11940-017-0475-0","article-title":"Treatment of blepharospasm\/hemifacial spasm","volume":"19","author":"Green","year":"2017","journal-title":"Curr Treat Options Neurol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0011","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1136\/bjo.87.1.54","article-title":"Botulinum toxin A treatment in patients suffering from blepharospasm and dry eye","volume":"87","author":"Horwath-Winter","year":"2003","journal-title":"Br J Ophthalmol"},{"issue":"11","key":"10.1016\/j.ajo.2026.09.016_bib0012","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.18240\/ijo.2024.11.05","article-title":"Correlation between blepharospasm and psychological diseases: the anxiety, depression and sleep disorder study","volume":"17","author":"Zhang","year":"2024","journal-title":"Int J Ophthalmol"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0013","article-title":"Effectiveness of 0.3% hyaluronic acid eye drops for benign essential blepharospasm and hemifacial spasm with botulinum toxin-induced dry eye","volume":"12","author":"Poonyathalang","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"6","key":"10.1016\/j.ajo.2026.09.016_bib0014","doi-asserted-by":"crossref","DOI":"10.5935\/0004-2749.2022-0160","article-title":"Profile of patients with essential blepharospasm and hemifacial spasm in the two largest ophthalmology reference centers in Brazil","volume":"87","author":"Fowler","year":"2023","journal-title":"Arq Bras Oftalmol"},{"issue":"11","key":"10.1016\/j.ajo.2026.09.016_bib0015","article-title":"Botulinum toxin type A therapy for hemifacial spasm","volume":"11","author":"Duarte","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0016","article-title":"Exploratory prospective randomized controlled study to evaluate a modified botulinum toxin injection pattern for treatment of benign essential blepharospasm","volume":"17","author":"Contento","year":"2025","journal-title":"Cureus"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0017","first-page":"1760","article-title":"Clinical application of botulinum toxin for hemifacial spasm","volume":"13","author":"Park","year":"2023","journal-title":"Life (Basel)"},{"issue":"13","key":"10.1016\/j.ajo.2026.09.016_bib0018","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1007\/s00266-025-04913-w","article-title":"Botulinum toxin injection for hemifacial spasm and benign essential blepharospasm: a systematic review and meta-analysis comparing pretarsal and preseptal injection techniques","volume":"49","author":"Noor","year":"2025","journal-title":"Aesthetic Plast Surg"},{"key":"10.1016\/j.ajo.2026.09.016_bib0019","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/164_2019_325","article-title":"Use of botulinum toxin in ophthalmology","volume":"263","author":"Wan","year":"2021","journal-title":"Handb Exp Pharmacol"},{"issue":"2","key":"10.1016\/j.ajo.2026.09.016_bib0020","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.1111\/aos.12002","article-title":"Tear production and drainage after botulinum toxin A injection in patients with essential blepharospasm","volume":"91","author":"Park","year":"2013","journal-title":"Acta Ophthalmol"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0021","doi-asserted-by":"crossref","first-page":"2625","DOI":"10.1007\/s10792-022-02253-1","article-title":"Tear meniscus, corneal topographic and aberrometric changes after botulinum toxin-a injection in patients with blepharospasm and hemifacial spasm","volume":"42","author":"Bayraktar Bilen","year":"2022","journal-title":"Int Ophthalmol"},{"issue":"6","key":"10.1016\/j.ajo.2026.09.016_bib0022","doi-asserted-by":"crossref","first-page":"830","DOI":"10.5301\/ejo.5000482","article-title":"Ocular surface alterations in blepharospasm patients treated with botulinum toxin A injection","volume":"24","author":"Kocabeyoglu","year":"2014","journal-title":"Eur J Ophthalmol"},{"issue":"3","key":"10.1016\/j.ajo.2026.09.016_bib0023","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1590\/S0004-27492006000300007","article-title":"Lacrimal film evaluation of patients with facial dystonia during botulinum toxin type A treatment]","volume":"69","author":"Costa","year":"2006","journal-title":"Arq Bras Oftalmol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0024","doi-asserted-by":"crossref","first-page":"8367","DOI":"10.1038\/s41598-018-26750-5","article-title":"Increase lipid tear thickness after botulinum neurotoxin A injection in patients with blepharospasm and hemifacial spasm","volume":"8","author":"Ho","year":"2018","journal-title":"Sci Rep"},{"issue":"5","key":"10.1016\/j.ajo.2026.09.016_bib0025","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.jcrs.2016.01.046","article-title":"Impact of botulinum toxin-A on corneal curvature assessed with Scheimpflug and Placido systems","volume":"42","author":"Osaki","year":"2016","journal-title":"J Cataract Refract Surg"},{"key":"10.1016\/j.ajo.2026.09.016_bib0026","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.ajo.2026.09.016_bib0027","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.ajo.2026.09.016_bib0028","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0029","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2021","journal-title":"Res Synth Methods"},{"key":"10.1016\/j.ajo.2026.09.016_bib0030","unstructured":"GRADEpro GDT: GRADEpro guideline development tool. McMaster University and Evidence Prime; 2023."},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0031","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12874-024-02356-6","article-title":"Meta-analysis accelerator: a comprehensive tool for statistical data conversion in systematic reviews with meta-analysis","volume":"24","author":"Abbas","year":"2024","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0032","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"10.1016\/j.ajo.2026.09.016_bib0033","series-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2024"},{"issue":"12","key":"10.1016\/j.ajo.2026.09.016_bib0034","doi-asserted-by":"crossref","first-page":"3615","DOI":"10.1007\/s00417-023-06141-x","article-title":"Relations between nonmotor manifestations and motor disorders in patients with benign essential blepharospasm","volume":"261","author":"Zhou","year":"2023","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"5","key":"10.1016\/j.ajo.2026.09.016_bib0035","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/IOP.0000000000002375","article-title":"Ocular surface metrics in blepharospasm patients after treatment with botulinum toxin injections","volume":"39","author":"Yabumoto","year":"2023","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"6","key":"10.1016\/j.ajo.2026.09.016_bib0036","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1590\/S0004-27492011000600006","article-title":"Ocular wave-front aberrations in patients with facial dystonia treated with botulinum toxin]","volume":"74","author":"Yabiku","year":"2011","journal-title":"Arq Bras Oftalmol"},{"key":"10.1016\/j.ajo.2026.09.016_bib0037","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jtos.2024.11.009","article-title":"The effect of botulinum neurotoxin A injections on meibomian glands and dry eye","volume":"35","author":"Sawaed","year":"2025","journal-title":"Ocul Surf"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0038","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1007\/s10792-023-02672-8","article-title":"Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm","volume":"43","author":"Romero-Caballero","year":"2023","journal-title":"Int Ophthalmol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0039","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3346\/jkms.2006.21.1.131","article-title":"The changes in corneal astigmatism after botulinum toxin-a injection in patients with blepharospasm","volume":"21","author":"Moon","year":"2006","journal-title":"J Korean Med Sci"},{"issue":"5","key":"10.1016\/j.ajo.2026.09.016_bib0040","first-page":"405","article-title":"[Botulinum toxin type A influence on the lacrimal function of patients with facial dystonia]","volume":"73","author":"de Oliveira","year":"2010","journal-title":"Arq Bras Oftalmol"},{"issue":"3","key":"10.1016\/j.ajo.2026.09.016_bib0041","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.ajo.2013.11.014","article-title":"The influence of benign essential blepharospasm on dry eye disease and ocular inflammation","volume":"157","author":"Lu","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.ajo.2026.09.016_bib0042","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.2147\/OPTH.S305817","article-title":"Dry eye disease in hemifacial spasm patients treated with botulinum toxin type A","volume":"15","author":"Jariyakosol","year":"2021","journal-title":"Clin Ophthalmol"},{"issue":"6","key":"10.1016\/j.ajo.2026.09.016_bib0043","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1007\/s10384-016-0469-6","article-title":"Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm: BTX improves dry eye in patients with BEB","volume":"60","author":"Isshiki","year":"2016","journal-title":"Jpn J Ophthalmol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0044","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s10384-019-00705-3","article-title":"Characteristics of tear abnormalities associated with benign essential blepharospasm and amelioration by means of botulinum toxin type A treatment","volume":"64","author":"Hosotani","year":"2020","journal-title":"Jpn J Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.09.016_bib0045","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1177\/11206721241266008","article-title":"Objective assessment of tear film in blepharospasm, facial hemispam and aberrant regeneration with periocular botulinum toxin-A","volume":"35","author":"Galindo-Ferreiro","year":"2025","journal-title":"Eur J Ophthalmol"},{"issue":"1","key":"10.1016\/j.ajo.2026.09.016_bib0046","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s10792-024-03277-5","article-title":"Does blepharospasm effect biometric parameters and intraocular lens power calculations?","volume":"44","author":"Basol","year":"2024","journal-title":"Int Ophthalmol"},{"issue":"2","key":"10.1016\/j.ajo.2026.09.016_bib0047","doi-asserted-by":"crossref","first-page":"74","DOI":"10.31348\/2019\/2\/3","article-title":"Effect of botulinum toxin A application in neuro-ophtalmologic indications on Schirmers test and tears osmolarity","volume":"75","author":"\u017diak","year":"2019","journal-title":"Cesk Slov Oftalmol"},{"issue":"9","key":"10.1016\/j.ajo.2026.09.016_bib0048","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.4103\/ijo.IJO_41_19","article-title":"Ocular surface status in patients with hemifacial spasm under long-lasting treatment with botulinum A toxin: a comparative fellow eye study","volume":"67","author":"Pellegrini","year":"2019","journal-title":"Indian J Ophthalmol"},{"issue":"5","key":"10.1016\/j.ajo.2026.09.016_bib0049","doi-asserted-by":"crossref","first-page":"430","DOI":"10.3341\/kjo.2016.0123","article-title":"Comparison of safety and efficacy of Botox and Neuronox in the management of benign essential blepharospasm: a split-face study","volume":"33","author":"Sane","year":"2019","journal-title":"Korean J Ophthalmol"},{"key":"10.1016\/j.ajo.2026.09.016_bib0050","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajo.2021.04.029","article-title":"Complications of preseptal versus pretarsal botulinum toxin injection in benign essential blepharospasm: a randomized controlled trial","volume":"232","author":"Sanguandikul","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.ajo.2026.09.016_bib0051","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/5957812","article-title":"Comparison of two botulinum neurotoxin A injection patterns with or without the medial lower eyelid in the treatment of blepharospasm","volume":"2016","author":"Yang","year":"2016","journal-title":"J Ophthalmol"},{"issue":"8","key":"10.1016\/j.ajo.2026.09.016_bib0052","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1097\/ICO.0000000000000482","article-title":"Corneal and tear film changes after botulinum toxin-A in blepharospasm or hemifacial spasm","volume":"34","author":"Gunes","year":"2015","journal-title":"Cornea"},{"issue":"12 Pt 2","key":"10.1016\/j.ajo.2026.09.016_bib0053","first-page":"1515","article-title":"Dry eyes and superficial punctate keratitis: a complication of treatment of glabelar dynamic rhytides with botulinum exotoxin A","volume":"30","author":"Northington","year":"2004","journal-title":"Dermatol Surg"}],"container-title":["American Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002939426005301?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002939426005301?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T09:00:44Z","timestamp":1794301244000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002939426005301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":53,"alternative-id":["S0002939426005301"],"URL":"https:\/\/doi.org\/10.1016\/j.ajo.2026.09.016","relation":{},"ISSN":["0002-9394"],"issn-type":[{"value":"0002-9394","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Impact of Botulinum Toxin on Ocular Surface Parameters in Patients With Orbicularis Spasm: A Systematic Review and Meta-Analysis","name":"articletitle","label":"Article Title"},{"value":"American Journal of Ophthalmology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajo.2026.09.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}