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含脂质与含透明质酸钠眼药水对光学质量和眼表参数的影响与睑板腺缺失率的关系

Effects of Lipid- Versus Sodium Hyaluronate-Containing Eye Drops on Optical Quality and Ocular Surface Parameters as a Function of the Meibomian Gland Dropout Rate.

作者信息

Miháltz Kata, Faschinger Eva Maria, Vécsei-Marlovits Pia Veronika

机构信息

Department of Ophthalmology, Hietzing Hospital, Vienna, Austria.

Karl Landsteiner Institute of Process Optimization and QM in Cataract Surgery, Vienna, Austria.

出版信息

Cornea. 2018 Jul;37(7):886-892. doi: 10.1097/ICO.0000000000001523.

Abstract

PURPOSE

To evaluate the effect of lipid- versus sodium hyaluronate-based eye drops on optical quality and ocular surface parameters.

METHODS

Sixty eyes of 30 patients with mild-to-moderate dry eye disease were included in a prospective randomized study. Each patient received either lipid- or sodium hyaluronate-based eye drops. Ocular symptom scores, breakup time, Schirmer test, fluorescein staining, noncontact meibography, and aberrometry were evaluated before and after 3 months of therapy.

RESULTS

At the 3-month visit, a statistically significant improvement (P ≤ 0.05) was noted in both groups on the Schirmer test, breakup time, ocular surface staining, and symptom score. In the lipid group, patients with progressive meibomian gland (MG) loss (>50%) showed a significantly greater increase in their corneal higher-order (HO) Strehl ratio (0.25 ± 0.26 vs. -0.01 ± 0.25, P = 0.02) and modulation transfer function (MTF) (0.12 ± 0.17 vs. -0.02 ± 0.06, P = 0.03) than patients with less advanced MG disease. In the lipid group, a significant positive correlation was noted between the MG dropout rate and improvement in Schirmer values [Spearman correlation coefficient (CC): 0.79], corneal HO Strehl (CC: 0.75), and HO modulation transfer function (CC: 0.6), but a significant negative correlation was noted between the MG dropout rate and the HO root mean square (CC: -0.73).

CONCLUSIONS

Lipid-containing artificial tears seem to be superior to sodium hyaluronate-containing drops in terms of improving HO aberrations and optical quality in patients with significant MG dysfunction.

摘要

目的

评估基于脂质的眼药水与基于透明质酸钠的眼药水对光学质量和眼表参数的影响。

方法

30例轻至中度干眼病患者的60只眼睛纳入一项前瞻性随机研究。每位患者接受基于脂质的眼药水或基于透明质酸钠的眼药水。在治疗3个月前后评估眼部症状评分、泪膜破裂时间、泪液分泌试验、荧光素染色、非接触式睑板腺造影和像差测量。

结果

在3个月随访时,两组在泪液分泌试验、泪膜破裂时间、眼表染色和症状评分方面均有统计学显著改善(P≤0.05)。在脂质组中,睑板腺(MG)损失进展(>50%)的患者角膜高阶(HO)斯特列尔比率(0.25±0.26对-0.01±0.25,P=0.02)和调制传递函数(MTF)(0.12±0.17对-0.02±0.06,P=0.03)的增加显著大于MG疾病较轻的患者。在脂质组中,MG缺失率与泪液分泌值改善[斯皮尔曼相关系数(CC):0.79]、角膜HO斯特列尔(CC:0.75)和HO调制传递函数(CC:0.6)之间存在显著正相关,但MG缺失率与HO均方根之间存在显著负相关(CC:-0.73)。

结论

在改善MG功能显著障碍患者的HO像差和光学质量方面,含脂质的人工泪液似乎优于含透明质酸钠的滴眼液。

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