微睑裂剥脱术对隐形眼镜不适相关临床因素的影响。

The Effect of Microblepharon Exfoliation on Clinical Correlates of Contact Lens Discomfort.

作者信息

Siddireddy Jaya Sowjanya, Tan Jacqueline, Vijay Ajay Kumar, Willcox Mark D P

机构信息

School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia *

出版信息

Optom Vis Sci. 2019 Mar;96(3):187-199. doi: 10.1097/OPX.0000000000001354.

DOI:10.1097/OPX.0000000000001354

PMID:30801507

Abstract

SIGNIFICANCE

Microblepharon exfoliation improved eyelid signs and tear film characteristics after a single in-office treatment in symptomatic contact lens wearers.

PURPOSE

The purpose of this study was to assess the effect of two eyelid hygiene treatments-microblepharon exfoliation and a hypoallergenic foam cleanser (LidHygenix)-on clinical signs of the eyelids, meibomian glands, and tear film in contact lens discomfort.

METHODS

A randomized, interventional, unmasked, crossover trial was conducted on 30 experienced daily-wear soft contact lens wearers. Assessment of clinical signs of the eyelid margin, meibomian gland morphology and secretion, and tear film biophysical properties was performed (baseline 1), and participants were randomly assigned to receive one of the two treatments (microblepharon exfoliation or foam cleansing using LidHygenix) as a single in-office procedure. Symptoms were evaluated using the Contact Lens Dry Eye Questionnaire-8 immediately after treatment, and assessment of all the study variables was repeated at the follow-up visit 7 to 10 days after treatment. After 28 to 30 days of washout, participants returned for reassessment of the study variables (baseline 2) and were crossed over to receive the alternate treatment. Follow-up was repeated 7 to 10 days after the second treatment.

RESULTS

Seven to 10 days after treatment with microblepharon exfoliation, symptomatic wearers showed significant improvement in anterior blepharitis (mean difference, 0.60; P = .04), lid wiper staining (0.50; P = .06), and lid-parallel conjunctival folds (0.68, P = .02) along with orifice capping (median difference, 0.65; P < .001), foam (0.90; P < .001), secretion volume (0.69; P < .001), quality (0.74; P < .001), and expressibility (0.49; P = .002), which were also clinically significant changes. However, in tear properties, significant improvements were observed in tear volume (LidHygenix, -1.25 mm; microblepharon exfoliation, -1.62 mm), break-up time (-0.14 seconds; -0.14 seconds), tear evaporation rate without contact lenses (21.52 g m h; 45.43 g m h), and lipid layer thickness (-20.61 nm; -25.13 nm) after both treatments but in symptomatic lens wearers only (P < .05).

CONCLUSIONS

Microblepharon exfoliation improved eyelid signs and tear film characteristics in symptomatic contact lens wearers after a single in-office treatment.

摘要

意义

对于有症状的隐形眼镜佩戴者，单次门诊治疗后，微睑板剥脱术改善了眼睑体征和泪膜特征。

目的

本研究的目的是评估两种眼睑卫生治疗方法——微睑板剥脱术和一种低敏泡沫洁面剂（LidHygenix）——对隐形眼镜不适患者的眼睑、睑板腺和泪膜临床体征的影响。

方法

对30名有经验的日戴型软性隐形眼镜佩戴者进行了一项随机、干预、非盲、交叉试验。对睑缘临床体征、睑板腺形态和分泌以及泪膜生物物理特性进行了评估（基线1），参与者被随机分配接受两种治疗方法之一（微睑板剥脱术或使用LidHygenix进行泡沫清洁）作为单次门诊手术。治疗后立即使用隐形眼镜干眼问卷-8评估症状，并在治疗后7至10天的随访中重复评估所有研究变量。经过28至30天的洗脱期后，参与者返回重新评估研究变量（基线2），并交叉接受另一种治疗。第二次治疗后7至10天重复随访。

结果

微睑板剥脱术治疗7至10天后，有症状的佩戴者在前睑缘炎（平均差异，0.60；P = 0.04）、睑板擦痕染色（0.50；P = 0.06）和睑平行结膜皱襞（0.68，P = 0.02）以及开口封堵（中位数差异，0.65；P < 0.001）、泡沫（0.90；P < 0.001）、分泌量（0.69；P < 0.001）、质量（0.74；P < 0.001）和可挤压性（0.49；P = 0.002）方面有显著改善，这些也是临床上的显著变化。然而在泪液特性方面，两种治疗后但仅在有症状的隐形眼镜佩戴者中观察到泪液量（LidHygenix，-1.25 mm；微睑板剥脱术，-1.62 mm）、破裂时间（-0.14秒；-0.14秒）、无隐形眼镜时的泪液蒸发率（21.52 g m h；45.43 g m h）和脂质层厚度（-20.61 nm；-25.13 nm）有显著改善（P < 0.05）。