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使用睑缘擦拭、眼药水和ω-3补充剂联合治疗对脂质缺乏/蒸发型干眼患者睑板腺功能的影响。

Effect of using a combination of lid wipes, eye drops, and omega-3 supplements on meibomian gland functionality in patients with lipid deficient/evaporative dry eye.

作者信息

Korb Donald R, Blackie Caroline A, Finnemore Victor M, Douglass Teresa

机构信息

Korb Associates, Boston, MA.

出版信息

Cornea. 2015 Apr;34(4):407-12. doi: 10.1097/ICO.0000000000000366.

Abstract

PURPOSE

The aim of this study was to assess the efficacy of using a combination treatment approach consisting of lipid emulsion eye drops, eyelid cleansing wipes, and omega-3 vitamin supplements compared with warm compresses in improving meibomian gland functionality in patients with lipid-deficient/evaporative dry eye disease (LDDE).

METHODS

This single-center, open-label, investigator-masked, randomized study enrolled patients aged ≥18 years, clinically diagnosed with LDDE defined as having ≤6 functional meibomian glands [meibomian gland yielding liquid secretion (MGYLS)] and positive for dry eye symptoms at screening. Patients were randomized to receive either the combination treatment (lipid emulsion eye drops, omega-3 supplements, and lid hygiene with eyelid wipes) or to apply warm, wet compresses once daily, 8 minutes per day, for 3 months. Meibomian gland functionality (number of MGYLS; primary outcome) and patient-reported subjective assessments (SPEED and OSDI questionnaires; secondary outcomes) were evaluated. Adverse events (AEs) and visual acuity were assessed as safety endpoints.

RESULTS

Mean patient age was 41.7 years (n = 26; n = 13 per group). Mean ± SD number of MGYLS was not statistically significantly different between groups at baseline (combination treatment, 3.5 ± 1.5; warm compresses, 4.2 ± 1.4, P > 0.5), and was significantly greater with combination treatment versus warm compresses after 3 months of treatment (9.3 ± 2.7 vs. 4.7 ± 2.3; P = 0.006). Dry eye symptoms were significantly improved in both groups at all follow-up visits. Two AEs unrelated to treatment were reported; the BCVA was unchanged from baseline in both groups.

CONCLUSIONS

The combination treatment regimen resulted in significant improvement in meibomian gland functionality and dry eye symptoms. No safety issues were observed.

摘要

目的

本研究旨在评估与热敷相比,使用由脂质乳化滴眼液、眼睑清洁湿巾和ω-3维生素补充剂组成的联合治疗方法改善脂质缺乏/蒸发型干眼疾病(LDDE)患者睑板腺功能的疗效。

方法

这项单中心、开放标签、研究者设盲的随机研究纳入了年龄≥18岁、临床诊断为LDDE(定义为功能性睑板腺≤6个[能产生液体分泌物的睑板腺(MGYLS)])且筛查时干眼症状呈阳性的患者。患者被随机分为接受联合治疗(脂质乳化滴眼液、ω-3补充剂和用眼睑湿巾进行眼睑卫生护理)或每天应用一次温湿热敷,每次8分钟,持续3个月。评估睑板腺功能(MGYLS数量;主要结局)和患者报告的主观评估(SPEED和OSDI问卷;次要结局)。评估不良事件(AE)和视力作为安全性终点。

结果

患者平均年龄为41.7岁(n = 26;每组n = 13)。基线时两组间MGYLS的平均±标准差数量无统计学显著差异(联合治疗组,3.5±1.5;热敷组,4.2±1.4,P>0.5),治疗3个月后联合治疗组的MGYLS数量显著多于热敷组(9.3±2.7对4.7±2.3;P = 0.006)。在所有随访中,两组的干眼症状均有显著改善。报告了2例与治疗无关的AE;两组的最佳矫正视力(BCVA)与基线相比均未改变。

结论

联合治疗方案使睑板腺功能和干眼症状得到显著改善。未观察到安全问题。

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