Kim Ho-Yun, Lee Ji-Eun, Oh Ha-Na, Song Ju-Whan, Han Sang-Youp, Lee Jong-Soo
Department of Ophthalmology, Maryknoll Medical Center, Busan 48972, South Korea.
Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea.
Int J Ophthalmol. 2018 Apr 18;11(4):593-600. doi: 10.18240/ijo.2018.04.09. eCollection 2018.
To investigate the efficacy of combined topical 0.05% cyclosporine A (CsA; Restasis, Allergan pharmaceuticals, USA) and 0.1% sodium hyaluronate treatment in dry eyes with meibomian gland dysfunction (MGD).
In a retrospective analysis, 53 patients (106 eyes) with MGD were enrolled and performed lid warm massage for 10min daily and be instilled preservative free sodium hyaluronate 0.1% eye drops 4 times daily. Patients were divided into subjects treated with topical 0.05% CsA and preservative free sodium hyaluronate vehicle (experimental group, =74 eyes) and subjects treated with the preservative free sodium hyaluronate vehicle (control group, =32 eyes). They were evaluated at baseline and 1, 2, and 3mo for subjective symptoms and objective signs including tear film break-up time (tBUT), Schirmer test, corneal staining (CS) score, lid margin telangiectasia (LMT), meibomian gland secretion (MGS), and conjunctival injection (CI).
In the short-term treatment, the experimental group showed a statistically significant improvement in the ocular surface disease index (OSDI; <0.001), tBUT (=0.004), Schirmer test score (=0.008) and LMT (=0.021) by repeated measure ANOVA. Additionally, mean changes from baseline in OSDI (<0.001), tBUT (=0.001), Schirmer test score (=0.029), CS score (=0.047), LMT (=0.002), CI (=0.030) were improved better in the experimental group than in the control group at 3mo. However, there was no significant difference between the two groups in MGS (=0.67).
In dry eyes with MGD, 0.05% CsA improves the tear film stability as well as subjective ocular discomfort, and is effective in controlling lid margin inflammation.
探讨局部联合应用0.05%环孢素A(CsA;Restasis,美国艾尔建制药公司)和0.1%透明质酸钠治疗睑板腺功能障碍(MGD)所致干眼的疗效。
进行一项回顾性分析,纳入53例(106只眼)MGD患者,每天进行10分钟睑部热敷按摩,并每天4次滴入不含防腐剂的0.1%透明质酸钠滴眼液。将患者分为局部应用0.05% CsA和不含防腐剂的透明质酸钠赋形剂治疗组(实验组,74只眼)和不含防腐剂的透明质酸钠赋形剂治疗组(对照组,32只眼)。在基线时以及第1、2和3个月对患者进行主观症状和客观体征评估,包括泪膜破裂时间(tBUT)、泪液分泌试验、角膜染色(CS)评分、睑缘毛细血管扩张(LMT)、睑板腺分泌(MGS)和结膜充血(CI)。
在短期治疗中,通过重复测量方差分析,实验组在眼表疾病指数(OSDI;P<0.001)、tBUT(P=0.004)、泪液分泌试验评分(P=0.008)和LMT(P=0.021)方面有统计学显著改善。此外,在3个月时,实验组OSDI(P<0.001)、tBUT(P=0.001)、泪液分泌试验评分(P=0.029)、CS评分(P=0.047)、LMT(P=0.002)和CI(P=0.030)相对于基线的平均变化比对照组改善得更好。然而,两组在MGS方面无显著差异(P=0.67)。
在MGD所致干眼中,0.05% CsA可改善泪膜稳定性以及主观眼部不适,并有效控制睑缘炎症。