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。
