{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:53:33Z","timestamp":1761710013467,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T00:00:00Z","timestamp":1674345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Natural Science Foundation of China","award":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"],"award-info":[{"award-number":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"]}]},{"name":"the National Natural Science Foundation of China","award":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"],"award-info":[{"award-number":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"]}]},{"name":"the Fundamental Research Funds for the Central Universities","award":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"],"award-info":[{"award-number":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"]}]},{"name":"the Key Research and Development Program of Hubei Province","award":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"],"award-info":[{"award-number":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"]}]},{"name":"the Clinical Research Foundation of Wuhan Union Hospital","award":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"],"award-info":[{"award-number":["82171025","82070934","2019kfyXMBZ065","2021BCA146","2021xhlcyj03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Blepharospasm patients often have dry eye manifestations. Botulinum neurotoxin type A (BoNT-A) injection has been the main management for blepharospasm and absorbable punctal plug (APP) insertion is shown to be effective in the treatment of dry eye. However, there have been no studies investigating the combined treatment of BoNT-A and APP in blepharospasm patients with dry eye. In this retrospective study, 17 blepharospasm patients with dry eye treated by BoNT-A injection and 12 receiving BoNT-A plus APP treatment were enrolled. The efficacy was evaluated according to the Jankovic rating scale, Ocular Surface Disease Index (OSDI), fluorescein staining (FL), fluorescein tear break-up time (FBUT) and Schirmer I test (SIT). Both BoNT-A and BoNT-A+APP treatment effectively reduced the functional impairment of blepharospasm. At baseline, all the patients had high OSDI scores (BoNT-A group: 82.48 \u00b1 7.37, BoNT-A+APP group: 78.82 \u00b1 4.60, p = 0.112), but relatively low degrees of FL (BoNT-A group: 3.18 \u00b1 1.01, BoNT-A+APP group: 3.50 \u00b1 1.24, p = 0.466), FBUT (BoNT-A group: 1.71 \u00b1 0.77, BoNT-A+APP group: 2.17 \u00b1 0.58, p = 0.077) and SIT (BoNT-A group: 2.53 \u00b1 0.99, BoNT-A+APP group: 3.17 \u00b1 1.23, p = 0.153). After treatment, OSDI, FL, FBUT and SIT were all obviously restored in the two groups. When comparing the changing rates, only OSDI (BoNT-A group: \u221252.23% \u00b1 15.57%, BoNT-A+APP group: \u221261.84% \u00b1 9.10%, p = 0.047) and FL (BoNT-A group: \u221222.55% \u00b1 25.98%, BoNT-A+APP group: \u221241.94% \u00b1 14.46%, p = 0.016) showed significant differences between the two groups. This study suggests that OSDI is not applicable in the diagnosis of dry eye among blepharospasm patients. For blepharospasm patients with severe dry eye symptoms, especially those with fluorescein staining in the cornea, the combined treatment of BoNT-A and APP is more effective than using BoNT-A alone.<\/jats:p>","DOI":"10.3390\/jcm12030877","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:50:41Z","timestamp":1674449441000},"page":"877","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Botulinum Neurotoxin Type a Injection Combined with Absorbable Punctal Plug Insertion: An Effective Therapy for Blepharospasm Patients with Dry Eye"],"prefix":"10.3390","volume":"12","author":[{"given":"Malachie","family":"Ndikumukiza","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Ting","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"You-Fan","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Song","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4027-691X","authenticated-orcid":false,"given":"Hua-Tao","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Chang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Duarte, G.S., Rodrigues, F.B., Marques, R.E., Castel\u00e3o, M., Ferreira, J., Sampaio, C., Moore, A.P., and Costa, J. 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