Albietz Julie M, Schmid Katrina L
School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Clin Exp Optom. 2017 Nov;100(6):603-615. doi: 10.1111/cxo.12524. Epub 2017 Jun 6.
The aim was to evaluate the efficacy of standardised Manuka (Leptospermum species) antibacterial honey as adjunctive twice daily treatment to conventional therapy (warm compresses, lid massage and preservative-free lubricant), in participants with evaporative dry eye due to moderate to advanced meibomian gland dysfunction.
This prospective, open-label study involved 114 participants. After two weeks of conventional therapy participants were randomised to one of three treatment groups: Optimel Antibacterial Manuka Eye Gel (98 per cent Leptospermum species honey) plus conventional therapy (n = 37), Optimel Manuka plus Lubricant Eye Drops (16 per cent Leptospermum species honey) plus conventional therapy (n = 37) and a control (conventional therapy) (n = 40). Clinical evaluations performed at baseline and Week 8 included: symptom scores (Ocular Surface Disease Index, Ocular Comfort Index), daily lubricant use, tear assessments (break-up time, secretion, osmolarity and InflammaDry), corneal sensation, ocular surface staining, meibomian gland secretion quality and expressibility, bulbar conjunctival, limbal and lid marginal redness and eyelid marginal bacterial cultures and colony counts.
Significant improvements (p ≤ 0.05) occurred at Week 8 in symptoms, tear break-up time, staining, tear osmolarity, meibum quality and bulbar, limbal and lid margin redness for all treatments. Improvement in staining was significantly greater with Optimel 16 per cent drops (p = 0.035). Significant improvements (p < 0.05) in meibomian gland expressibility and InflammaDry occurred for both Optimel treatments. Optimel 98 per cent gel was significantly more effective in improving meibum quality (p = 0.005) and gland expressibility (p = 0.042). Total eyelid marginal bacterial colony counts reduced significantly with Optimel 16 per cent drops (p = 0.03) but not the other treatments. Staphylococcus epidermidis counts reduced significantly with Optimel 16 per cent drops (p = 0.041) and Optimel 98 per cent gel (p = 0.027). Both Optimel treatments significantly reduced the need for lubricants, with Optimel 16 per cent drops decreasing lubricant use most (p = 0.001). Temporary redness and stinging were the only adverse effects of Optimel use.
Optimel antibacterial honey treatments are effective as adjunctive therapies for meibomian gland dysfunction.
本研究旨在评估标准化麦卢卡（Leptospermum属）抗菌蜂蜜作为辅助治疗，每日两次联合传统疗法（热敷、睑板按摩和无防腐剂润滑剂），对中重度睑板腺功能障碍引起的蒸发型干眼患者的疗效。
这项前瞻性、开放标签研究纳入了114名参与者。在接受两周传统治疗后，参与者被随机分为三个治疗组之一：Optimel抗菌麦卢卡眼凝胶（98%的Leptospermum属蜂蜜）联合传统疗法（n = 37）、Optimel麦卢卡加润滑剂滴眼液（16%的Leptospermum属蜂蜜）联合传统疗法（n = 37）以及对照组（传统疗法）（n = 40）。在基线和第8周进行的临床评估包括：症状评分（眼表疾病指数、眼部舒适度指数）、每日润滑剂使用情况、泪液评估（泪膜破裂时间、分泌物、渗透压和InflammaDry）、角膜感觉、眼表染色、睑板腺分泌物质量和可挤压性、球结膜、角膜缘和睑缘发红情况以及睑缘细菌培养和菌落计数。
在第8周时，所有治疗组在症状、泪膜破裂时间、染色、泪液渗透压、睑脂质量以及球结膜、角膜缘和睑缘发红方面均有显著改善（p≤0.05）。16%的Optimel滴眼液在染色改善方面显著更优（p = 0.035）。两种Optimel治疗在睑板腺可挤压性和InflammaDry方面均有显著改善（p<0.05）。98%的Optimel凝胶在改善睑脂质量（p = 0.005）和腺体可挤压性（p = 0.042）方面显著更有效。16%的Optimel滴眼液使睑缘细菌菌落总数显著减少（p = 0.03），而其他治疗组未出现此情况。表皮葡萄球菌计数在16%的Optimel滴眼液治疗组（p = 0.041）和98%的Optimel凝胶治疗组（p = 0.027）中显著减少。两种Optimel治疗均显著减少了润滑剂的使用需求，其中16%的Optimel滴眼液减少润滑剂使用最多（p = 0.001）。使用Optimel的唯一不良反应是短暂的发红和刺痛。
Optimel抗菌蜂蜜治疗作为睑板腺功能障碍的辅助疗法有效。
