强脉冲光联合睑板腺按摩治疗睑板腺功能障碍相关干眼的效果

Efficacy of intense pulsed light combined with meibomian gland massage in the treatment of dry eye associated with meibomian gland dysfunction

目的评估强脉冲光(IPL)联合睑板腺按摩治疗睑板腺功能障碍(MGD)相关干眼的效果。方法回顾性队列研究。纳入宁波大学附属第一医院2020年1月至2023年12月收治的MGD相关干眼86例(172只眼)。按治疗方法不同分为两组:采用玻璃酸钠滴眼液常规治疗的43例作为对照组,在常规治疗基础上采用IPL联合睑板腺按摩治疗的43例作为治疗组。两组均连续治疗3个月,对两组治疗前后睑板腺功能、眼表疾病指数量表(OSDI)评分、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)和生存质量量表(SQOL-DVI)评分、并发症等进行比较。结果治疗后两组睑板腺功能、OSDI评分降低,BUT、SⅠt水平和SQOL-DVI评分提升。治疗组睑板腺功能评分(2.07±0.31)分,OSDI评分(25.33±3.79)分,均低于对照组[(4.30±0.64)分和(32.48±4.87)分](t=20.56、7.59,均P<0.001)。治疗组BUT、SⅠt水平分别为(5.55±0.83)分和(5.28±0.79)分,均高于对照组[(4.84±0.72)分和(4.57±0.68)分](t=4.24、4.47,均P<0.001),治疗组SQOL-DVI各维度评分高于对照组(t=4.49、4.22、4.44、3.70,均P<0.001);两组不良反应发生率均为4.65%(2/43),比较差异无统计学意义(χ^(2)=0.01,P=1.000)。结论IPL联合睑板腺按摩治疗可改善MGD相关干眼的临床症状和睑板腺功能,有效提高角膜稳定性和生活质量水平。

Objective To investigate the clinical efficacy of intense pulsed light(IPL)combined with meibomian gland massage in the treatment of dry eye associated with meibomian gland dysfunction(MGD).Methods Retrospective cohort study was used in this research.A total of 172 eyes of 86 patients with MGD related dry eye treated in the First Affiliated Hospital of Ningbo University from Jan.2020 to Dec.2023 were selected and divided into two groups based on different treatments.Forty-three patients received conventional treatment with sodium hyaluronate eye drops were selected as the control group,and another 43 cases of IPL combined with meibomian gland massage on the basis of conventional treatment were selected as the treatment group.The two groups were treated continuously for 3 months.Meibomian gland function,ocular surface disease index(OSDI)score,tear film break-up time(BUT),SchimerⅠtest(SⅠt),the scale of life quality for diseases with visual impairment(SQOL-DVI)and incidence of adverse events were compared between the two groups before and after treatment.Results After treatment,the meibomian gland function and OSDI scores of the two groups decreased,BUT,SⅠt and SQOL-DVI scores increased.The meibomian gland function score and OSDI score of the treatment group were(2.07±0.31)points and(25.33±3.79)points,which were lower than those of the control group[(4.30±0.64)points and(32.48±4.87)points](t=20.56,7.59;all P<0.001).BUT[(5.55±0.83)points]and SⅠt[(5.28±0.79)points]in the treatment group were higher than those in the control group[(4.84±0.72)points and(4.57±0.68)points](t=4.24,4.47;all P<0.001).The scores of SQOL-DVI in the treatment group were higher than those in the control group(t=4.49,4.22,4.44,3.70;all P<0.001).The incidence of adverse reactions in the two groups was 4.65%(2/43),and the difference was not statistically significant(χ^(2)=0.001,P=1.000).Conclusion Application of IPL combined with meibomian gland massage in the treatment of dry eye associated with MGD is conducive to the improvement of clinical symptoms and Meibomian gland function,and can effectively and safely improve corneal stability and quality of life.