{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:46:48Z","timestamp":1792633608379,"version":"4.5.0"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2020R1A2C4002095"],"award-info":[{"award-number":["2020R1A2C4002095"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: To evaluate the clinical efficacy of periocular botulinum toxin A (BTA) injection in patients with intractable dry eye disease (DED). Materials and Methods: Medical records of patients with intractable DED who underwent periocular BTA injection from December 2019 to March 2020 were reviewed retrospectively. Patients were injected with 2.5 units of BTA in the medial part of the lower eyelids. The clinical data collected included age, sex, ocular surface disease index (OSDI) score, tear film break up time (TBUT), Schirmer test results, tear osmolarity (I-PEN), and tear meniscus height (TMH) measured by anterior segment optical coherence tomography. All subjective and objective data were collected before treatment and at 1 month after treatment. Results: Twenty-eight consecutive patients were eligible for chart review and analysis. Significant improvements in OSDI, tear osmolarity, and TMH were observed at 1 month after periorbital BTA injection. At the baseline and 1-month follow-up examinations, OSDI scores were 62.22 \u00b1 21.30 and 47.98 \u00b1 17.23, respectively (p &lt; 0.001). TMH increased significantly after treatment (82.25 \u00b1 40.50 at baseline vs. 138.02 \u00b1 66.62 1-month after treatment; p &lt; 0.001). Tear osmolarity using I-PEN showed a significant decrease after treatment (320.82 \u00b1 24.66 at baseline vs. 302.75 \u00b1 22.33 at 1 month after treatment; p &lt; 0.001). No significant differences were found in TBUT or Schirmer test results before and after BTA injection. Conclusions: BTA injection into the medial part of the eyelid improves dry eye symptoms, the amount of tear retention, and tear osmolarity. Based on the objective parameters of the tear condition, this study supports the idea of BTA use as a potential treatment option for patients with intractable DED.<\/jats:p>","DOI":"10.3390\/medicina57030247","type":"journal-article","created":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T23:17:14Z","timestamp":1615159034000},"page":"247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Botulinum Toxin A Injection for the Treatment of Intractable Dry Eye Disease"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1061-532X","authenticated-orcid":false,"given":"Eun Woo","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170, Jomaru-ro, Bucheon 14584, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ju","family":"Yeom","sequence":"additional","affiliation":[{"name":"Gangnam Smile Eye Clinic, 6F, Tongyeong Building, 405, Gangnam-daero, Seocho-gu, Seoul 06615, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4723-3712","authenticated-orcid":false,"given":"Sun Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170, Jomaru-ro, Bucheon 14584, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jtos.2017.05.005","article-title":"TFOS DEWS II Introduction","volume":"15","author":"Nelson","year":"2017","journal-title":"Ocul. 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