Lee Hun, Kim Minseo, Park Si Yoon, Kim Eung Kweon, Seo Kyoung Yul, Kim Tae-Im
Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea.
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Clin Exp Optom. 2017 Nov;100(6):598-602. doi: 10.1111/cxo.12532. Epub 2017 Mar 12.
The aim was to investigate the efficacy of mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses in participants with moderate and severe meibomian gland dysfunction (MGD).
In this prospective, uncontrolled, open label, intervention study, 32 eyes of 32 participants with moderate and severe MGD were treated with mechanical squeezing of meibomian glands in combination with eyelid scrubs and warm compresses. We evaluated tear film break-up time (TBUT), corneal and conjunctival fluorescein staining scores, biomicroscopic examination of lid margins and meibomian glands, Ocular Surface Disease Index (OSDI) questionnaire and tear film lipid layer thickness determined via an interferometer before initiating treatment and after one month of treatment.
There were significant improvements in TBUT, corneal and conjunctival fluorescein staining scores, lid margin abnormality, meibum quality and expressibility, OSDI and MGD stage after mechanical meibomian gland squeezing combined with eyelid scrubs and warm compresses (p < 0.001 for TBUT, corneal fluorescein staining scores, Dry Eye Workshop score, Oxford staining score, lid margin abnormality, meibum quality, expressibility, OSDI and MGD stage and p = 0.001 for conjunctival fluorescein staining scores). There were no significant differences in lipid layer thickness or interferometer-derived parameters before treatment and after one month of treatment. Palpebral conjunctival erosion detected after the squeezing treatment resolved spontaneously in all participants.
Mechanical squeezing of meibomian glands combined with eyelid scrubs and warm compresses can provide clinical benefits without serious adverse events.
本研究旨在探讨睑板腺机械挤压联合眼睑擦洗及热敷对中重度睑板腺功能障碍（MGD）患者的疗效。
在这项前瞻性、非对照、开放标签的干预研究中，对32例中重度MGD患者的32只眼睛进行睑板腺机械挤压联合眼睑擦洗及热敷治疗。在开始治疗前及治疗1个月后，我们评估了泪膜破裂时间（TBUT）、角膜和结膜荧光素染色评分、睑缘和睑板腺的生物显微镜检查、眼表疾病指数（OSDI）问卷以及通过干涉仪测定的泪膜脂质层厚度。
睑板腺机械挤压联合眼睑擦洗及热敷后，TBUT、角膜和结膜荧光素染色评分、睑缘异常、睑脂质量和排出能力、OSDI及MGD分期均有显著改善（TBUT、角膜荧光素染色评分、干眼研讨会评分、牛津染色评分、睑缘异常、睑脂质量、排出能力、OSDI及MGD分期p<0.001，结膜荧光素染色评分p = 0.001）。治疗前及治疗1个月后，脂质层厚度或干涉仪衍生参数无显著差异。挤压治疗后检测到的睑结膜糜烂在所有参与者中均自发缓解。
睑板腺机械挤压联合眼睑擦洗及热敷可带来临床益处，且无严重不良事件。
