Effectiveness of Minimally Invasive Partial Orbicularis Myectomy for Treating Benign Essential Blepharospasm: A Study Using the Jankovic Scale and Blepharospasm Disability Index.

Abstract

Purpose: This study aimed to evaluate the effectiveness of minimally invasive partial orbicularis myectomy in treating benign essential blepharospasm while assessing the utility of the Jankovic Rating Scale and Blepharospasm Disability Index as comprehensive outcome measures.

Methods: A retrospective study was conducted on 18 patients (36 eyes) with benign essential blepharospasm who underwent partial orbicularis myectomy between 2018 and 2022. All patients had previously shown inadequate response to botulinum toxin injections. Jankovic Rating Scale and Blepharospasm Disability Index scores were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively to capture both symptom severity and functional impact. Statistical analysis was performed using the Wilcoxon signed-rank test.

Results: The median preoperative Jankovic Rating Scale score of 7.5 decreased to 3 one year postoperatively, reflecting a 50% improvement in symptom severity. Concurrently, the median Blepharospasm Disability Index score reduced from 20 to 9.5, indicating a 47.22% enhancement in functional capacity at 1 year. Both reductions were statistically significant ( p < 0.001) and sustained throughout the 1-year follow-up period. No significant complications were reported.

Conclusion: Minimally invasive partial orbicularis myectomy demonstrates significant and sustained improvement in both symptom severity and functional disability in patients with benign essential blepharospasm refractory to botulinum toxin treatment. The combined application of Jankovic Rating Scale and Blepharospasm Disability Index proves to be an effective approach in evaluating surgical outcomes, offering valuable insights into both the clinical efficacy of partial orbicularis myectomy and its impact on patients' daily functioning.