睑板腺按摩联合普拉洛芬滴眼对白内障术后干眼症患者疗效的影响观察

Therapeutic effect of meibomian gland massage combined with pranoprofen eye drops on patients with dry eye after cataract surgery

目的 探究睑板腺按摩联合普拉洛芬滴眼对白内障术后干眼症患者的疗效。方法 选取2021年1月—2024年1月洛阳市第三人民医院收治的白内障术后睑板腺功能障碍(meibomian gland dysfunction, MGD)所致干眼症患者作为研究对象,采用随机数字表法将236例患者分为对照组与试验组,其中对照组(n=118)采用普拉洛芬滴眼液治疗,试验组(n=118)在对照组基础上进行睑板腺按摩,比较两组疗效、角膜荧光素染色(fluorescein staining, FL)评分及眼泪分泌试验(schirmer I test, SIT)、眼表临床指标、视觉质量、不良反应。结果 试验组治疗有效率为94.07%,显著高于对照组的82.20%(P<0.05);试验组FL评分低于对照组,SIT高于对照组(P<0.05);两组泪河高度、首次非侵入性泪膜破裂时间(non-invasive first tear film breakup time, NIBUTf)以及平均NIBUT(non-invasive average tear film breakup time, NIBUTav)较治疗前上升,眼表疾病指数(OSDI)评分较治疗前下降(P<0.05);试验组泪河高度、NIBUTf以及NIBUTav高于对照组,OSDI评分低于对照组(P<0.05);两组治疗后视觉质量问卷各指标评分较治疗前下降,试验组低于对照组;两组治疗期间发生的不良反应包括结膜水肿、眼睑水肿以及瘙痒,试验组(7.63%)与对照组(11.02%)不良反应发生率比较未见统计学差异(P>0.05)。结论 对白内障术后MGD所致干眼症患者采用睑板腺按摩联合普拉洛芬滴眼治疗效果显著,两种方式联合可改善患者睑板腺功能以及提升视觉质量,可用于临床推广。

Objective To explore the therapeutic effect of meibomian gland massage combined with pranoprofen eye drops on patients with dry eye after cataract surgery.Methods A total of 236 patients with dry eye caused by meibomian gland dysfunction(MGD)after cataract surgery who were admitted to the Luoyang the Third Peoples Hospital from January 2021 to January 2024 were selected as the study subjects.Using the random number table method,they were divided into the control group and the experimental group.Patients in the control group(n=118)were treated with pranoprofen eye dropswhile those in the experimental group(n=118)were given meibomian gland massage on the basis of the control group.The two groups were compared on therapeutic effects,corneal fluorescein staining(FL)score,Schirmer I test(SIT)results,clinical ocular surface indicators,visual quality,and adverse reactions.Results Compared to control group,there was an increase in the effective rate in the experimental group(82.20%vs 94.07%,P<0.05).Compared to control group,there was a decrease in FL score and an increase in SIT result in the experimental group(P<0.05).After treatment,there were increases in tear meniscus height,non-invasive first tear film breakup time(NIBUTf)and non-invasive average tear film breakup time(NIBUTav),and decreases in ocular surface disease index(OSDI)in both groups(P<O.05).Tear meniscus height,NIBUTf and NIBUTav of the experimental group were higher than those of the control group,and OSDI score was lower than that of the control group(P<0.05).After treatment,the visual quality questionnaire scores of both groups decreased,and the experimental group had lower scores.The occurrence rates of adverse reactions in the experimental group and the control group were 7.63%and 11.02%,without statistically significant difference between groups(P>0.05).Conclusion Meibomian gland massage combined with pranoprofen eye drops can achieve significant therapeutic efect on patients with dry eye caused by MGD after cataract surgery,which can improve meibomian gland function and enhance visual quality.