Wang Da-Hu, Liu Xin-Quan, Hao Xiao-Jun, Zhang Yin-Jian, Zhu Hua-Ying, Dong Zhi-Guo
Department of Ophthalmology, Longhua Hospital Shanghai, University of TCM, Shanghai, China.
Department of Ophthalmology, Shanghai Punan Hospital, Shanghai, China.
Cornea. 2018 Oct;37(10):1270-1278. doi: 10.1097/ICO.0000000000001682.
To investigate the effect of the meibomian gland squeezer for treatment of meibomian gland dysfunction (MGD).
Seventy patients (140 eyes) with MGD were randomly divided into 2 groups: 36 patients who were treated by the meibomian gland squeezer as the treatment group and 34 patients were selected as the control group. Patients were evaluated at baseline, and 2-week and 1-month visits for subjective symptoms, objective signs and pain assessments, including ocular symptom scores, Ocular Surface Disease Index, tear breakup time, corneal fluorescein staining, Schirmer scores with no anesthetic (Schirmer I test), meibum quality, meibum expressibility, and Numeric Rating Scale-11.
Sixty-five patients were followed in the study, and mean (±SD) age was 57.0 (±12.6) years. Compared with baseline, the 2 groups had varying degrees of improvement in ocular symptom scores and Ocular Surface Disease Index at the 2-week and 1-month visits; there was a statistically significant difference between groups (P < 0.001). At the 1-month visit, the treatment group showed a greater improvement in the breakup time (3.8 ± 1.6 vs. 1.8 ± 1.0 seconds, P < 0.001), corneal fluorescein staining (-2.1 ± 2.13 vs. -0.9 ± 1.3, P = 0.03), Schirmer I test (5.3 ± 2.9 vs. 2.3 ± 2.8 mm, P < 0.001), meibum quality (-7.5 ± 2.9 vs. -5.3 ± 2.4, P = 0.004), and meibum expressibility (-1.2 ± 0.8 vs. -0.7 ± 0.4, P = 0.007). In the treatment group, the mean (±SD) of total pain scores was 2.4 ± 1.0, which indicated that mild pain was still predominant under topical anesthesia.
The meibomian gland squeezer may be safe, effective, and helpful for treatment of MGD and may offer an attractive treatment option for some patients with MGD, although it can cause mild pain or discomfort.
探讨睑板腺挤压术治疗睑板腺功能障碍(MGD)的效果。
将70例(140只眼)MGD患者随机分为2组:36例采用睑板腺挤压术治疗的患者作为治疗组,34例患者作为对照组。在基线时以及随访2周和1个月时对患者进行主观症状、客观体征和疼痛评估,包括眼部症状评分、眼表疾病指数、泪膜破裂时间、角膜荧光素染色、无麻醉下的泪液分泌试验(Schirmer I试验)、睑脂质量、睑脂排出能力以及数字评分量表-11。
65例患者纳入本研究,平均(±标准差)年龄为57.0(±12.6)岁。与基线相比,两组在随访2周和1个月时眼部症状评分和眼表疾病指数均有不同程度改善;组间差异有统计学意义(P < 0.001)。在随访1个月时,治疗组的泪膜破裂时间(3.8 ± 1.6 vs. 1.8 ± 1.0秒,P < 0.001)、角膜荧光素染色(-2.1 ± 2.13 vs. -0.9 ± 1.3,P = 0.03)、Schirmer I试验(5.3 ± 2.9 vs. 2.3 ± 2.8毫米,P < 0.001)、睑脂质量(-7.5 ± 2.9 vs. -5.3 ± 2.4,P = 0.004)和睑脂排出能力(-1.2 ± 0.8 vs. -0.7 ± 0.4,P = 0.007)改善更明显。治疗组总疼痛评分的平均值(±标准差)为2.4 ± 1.0,这表明表面麻醉下仍以轻度疼痛为主。
睑板腺挤压术治疗MGD可能是安全、有效的,对部分MGD患者可能是一种有吸引力的治疗选择,尽管它可能会引起轻度疼痛或不适。