ReviewHealth science reports2026
Is Current Evidence Sufficient to Establish the Efficacy of Botulinum Toxin A in Treating Persistent Dry Eye Disease? A Systematic Review and Meta-Analysis of Interventional Studies With a Critical Review Using GRADE Tool.
Review in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Standard management of dry eye disease (DED) relies on artificial tears, anti-inflammatory therapy, and punctal occlusion in selected cases. However, some patients continue to report persistent symptoms. The present article reviewed the efficacy of Botulinum Toxin A (BTX-A) for DED that remained symptomatic after these interventions, excluding patients with blepharospasm or hemifacial spasm. Methods: We conducted a comprehensive search of seven databases (PubMed, Embase, Web of Science, Scopus, CENTRAL, Science Direct, and ProQuest), supplemented by grey literature searches (ProQuest, Scopus, OATD), hand-searching key ophthalmology journals, and investigating clinical trial registries (ClinicalTrials. gov, ICTRP, ISRCTN). Inclusion criteria were clinical trials and cohort studies assessing BTX-A in primary DED. Outcomes included tear break-up time (TBUT), Schirmer's test, and Ocular Surface Disease Index (OSDI). Meta-analyses utilized STATA 17, combining standardized mean differences (SMD) for TBUT and Schirmer's test, and mean difference (MD) for OSDI. Evidence certainty was evaluated using GRADE. Results: Out of 5,064 records, five studies (144 eyes) were included. Meta-analysis indicated no significant improvements in TBUT (Hedges's g = 0.43, 95% CI: -1.34 to 2.20) or Schirmer's test (Hedges's g = 0.23, 95% CI: -0.78 to 1.24). However, OSDI scores showed a significant reduction (MD -14.23; 95% CI: -15.86 to -12.59, Conclusions: BTX-A injections appear to offer symptom relief in persistent DED, though effects on objective measures remain inconclusive, limited by heterogeneity and low power. While initial safety data is favorable, the small number of methodologically weak studies highlights the need for larger, high-quality trials to clarify BTX-A's clinical role. PROSPERO Registration: CRD420251031877.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.