Establishment and Clinical Value Analysis of a Nomogram Model for Predicting Ptosis After Botulinum Toxin Type A Injection in the Treatment of Benign Essential Blepharospasm
WANG Beibei
YANG Fan
Abstract：Objective To investigate the risk factors for ptosis following botulinum toxin type A(BTX-A)injection in the treatment of benign essential blepharospasm(BEB)and to construct a risk-predictive nomogram model.Methods A retrospective analysis was conducted on 156 BEB patients who underwent BTX-A injection at Zhengzhou Second People's Hospital from January 2021 to February 2025.Independent risk factors identified by multivariate logistic regression were used to develop the nomogram model.The model's discriminative ability and calibration were validated using receiver operating characteristic curves and calibration curves,while decision curve analysis assessed its clinical applicability.Results Univariate analysis showed no significant differences in gender,age,body mass index,or disease duration between groups(P＞0.05).Multivariate logistic regression revealed that injection site(proximity to the levator aponeurosis insertion),injection depth(penetration into the deep orbital septum),unilateral injection dose(total dose＞25 U),and postoperative eye rubbing were independent risk factors for ptosis after BTX-A.The nomogram model based on these factors demonstrated good predictive performance upon internal validation,with calibration curves showing high consistency between predicted probabilities and actual incidence.Conclusion Precise injection techniques(such as avoiding the levator aponeurosis target area and controlling injection depth)and postoperative patient behavior management(such as refraining from eye rubbing)are critical for reducing ptosis risk.The established nomogram model provides clinicians with an individualized risk assessment tool to optimize injection protocols and preventive strategies.
Keywords：benign essential blepharospasmptosisbotulinum toxin type A injectionregression analysisnomogram model
Publication Date：2026-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 846-849 )