睑板腺压榨治疗睑板腺开口阻塞的疗效观察

Meibomian Gland Compression in Meibomian Gland Orifice Occlusion

目的观察睑板腺压榨治疗睑板腺开口阻塞伴眼表面不适的疗效和睑板腺分泌物的细胞组成。方法选择2006年1—8月就诊于我科门诊的28例睑板腺开口阻塞伴眼表面不适患者(睑板腺积分均≥3分),对所有患者行睑板腺压榨治疗,以国际眼表面疾病指数(OSDI)积分法等评价其疗效。结果治疗后大部分患者睑板腺开口变为通畅,眼部不适明显缓解;睑板腺积分治疗前为(3.9±1.0)分,治疗后为(1.2±0.8)分,差异有统计学意义(P<0.05);OSDI积分治疗前为(47.9±12.9)分,治疗后为(12.1±4.1)分,差异有统计学意义(P<0.05);治疗后2例于次日出现结膜下出血,8例出现眼分泌物增多;26例睑板腺分泌物涂片见少量上皮细胞,2例涂片见多量中性粒细胞和少量上皮细胞。结论睑板腺开口阻塞是引起眼表面不适的重要原因之一,睑板腺压榨是有效的治疗措施,这种治疗措施对于缓解症状、提高睑板腺分泌作用明显;小部分睑板腺开口阻塞可能与感染和炎症有关。

Objective To observe the therapeutic effect of meibomian gland compression in treatment of meibomian gland orifice occlusion complicated by ocular surface discomfort and the cell composition of mcibomian gland secretions. Methods Twenty eight outpatients with meibomian gland orifice occlusion complicated by ocular discomfort （meibomian score 1〉 3 ） were treated with Meibomian gland compression, and Ocular Surface Disease Index （OSDI） was used to evaluate its therapeutic effect. Results Meibomian gland openings became unobstructed and discomfort was improved obviously. Meibomian gland score was 3.9 ± 1.0 before treatment and 1.2 ±0. 8 after, the difference was significant （P 〈0. 05）. OSDI score was 47. 9± 12. 9 before treatment and 12. 1±4. 1 after, the difference was significant （P 〈0. 05）. After treatment, subconjunctival hemorrhage occurred in 2 patients and eye discharge increased in 8 on the next day. A small number of epithelial ceils were seen in 26 patients and a large number of neutrophils and a small number of epithelial cells in 2 on meibomian gland secretion smears. Conclusion Meibomina gland orifice occlusion is a major cause for ocular discomfort. Meibomian gland compression, having obvious effect in alleviating the symptoms and improving secretion of meibomian gland, is an effective treatment. Infection and inflammation may be involved in some meibomian gland orifice obstructions.