Tanabe Hirotaka, Kaido Minako, Kawashima Motoko, Ishida Reiko, Ayaki Masahiko, Tsubota Kazuo
Department of Ophthalmology, Keio University School of Medicine.
Department of Ophthalmology, Ashikaga Red Cross Hospital.
J Oleo Sci. 2019 Jan 1;68(1):67-78. doi: 10.5650/jos.ess18161. Epub 2018 Dec 12.
To investigate the efficacy of eyelid margin cleansing with lid hygiene detergent in patients with obstructive meibomian gland dysfunction (MGD).
As a pilot study, we investigated the safety and efficacy of lid hygiene using tap water and/or lid hygiene shampoo in fourteen eyes of 7 normal subjects. All subjects were instructed to cleanse the eyelid margin with tap water and/or lid hygiene shampoo. As a main prospective clinical study, thirty-four eyes of 34 patients with obstructive MGD were enrolled. All subjects were instructed to cleanse the eyelid margin with lid hygiene shampoo at least once daily for 1 month. Ocular surface conditions were observed before and 1 month after study initiation.
A significant exacerbating change (p < 0.05) was not detected after either method in the pilot study. In the main study, significant improvements were observed in tear break-up time (TBUT), lid margin lissamine green staining scores, vascular dilatation, and meibum status (p < 0.05). No significant improvements in corneal or conjunctival fluorescein staining scores, the mucocutaneous junction, lid margin deformation, or plugging were observed (p ≥ 0.05). Subjective improvements were observed in 27 subjects. Meibography revealed that 28 subjects had normal meibomian glands, and 6 subjects had meibomian gland atrophy. Significant improvements were observed in TBUT, vascular dilatation, and meibum status only in the group with normal meibomian glands (p < 0.05), but subjective symptoms and lid margin lissamine green staining scores improved in both groups (p < 0.05). No subjects experienced any problems throughout the study.
Daily routine use of lid hygiene detergent can alleviate the symptoms of MGD regardless of meibomian gland atrophy.
探讨使用睑缘清洁洗涤剂清洁睑缘对阻塞性睑板腺功能障碍（MGD）患者的疗效。
作为一项初步研究，我们调查了7名正常受试者14只眼中使用自来水和/或睑缘清洁洗发水进行睑缘清洁的安全性和有效性。所有受试者均被指导用自来水和/或睑缘清洁洗发水清洁睑缘。作为一项主要的前瞻性临床研究，纳入了34例阻塞性MGD患者的34只眼。所有受试者均被指导每天至少用睑缘清洁洗发水清洁睑缘1个月。在研究开始前和开始后1个月观察眼表状况。
在初步研究中，两种方法后均未检测到显著的恶化变化（p<0.05）。在主要研究中，泪膜破裂时间（TBUT）、睑缘丽丝胺绿染色评分、血管扩张和睑脂状态均有显著改善（p<0.05）。角膜或结膜荧光素染色评分、黏膜皮肤交界处、睑缘变形或堵塞均未观察到显著改善（p≥0.05）。27名受试者有主观改善。睑板腺造影显示，28名受试者睑板腺正常，6名受试者睑板腺萎缩。仅在睑板腺正常的组中，TBUT、血管扩张和睑脂状态有显著改善（p<0.05），但两组的主观症状和睑缘丽丝胺绿染色评分均有改善（p<0.05）。在整个研究过程中，没有受试者出现任何问题。
无论睑板腺萎缩与否，日常使用睑缘清洁洗涤剂均可缓解MGD的症状。
