Arita Reiko, Fukuoka Shima, Mizoguchi Takanori, Morishige Naoyuki
Department of Ophthalmology, Itoh Clinic, 626-11 Minami-Nakano, Minumaku, Saitama, Saitama 337-0042, Japan.
Lid and Meibomian Gland Working Group (LIME), Tokyo 112-0006, Japan.
J Clin Med. 2020 Oct 28;9(11):3467. doi: 10.3390/jcm9113467.
Aqueous-deficient dry eye (ADDE) and meibomian gland dysfunction (MGD) can be refractory to therapy. Intense pulsed light (IPL) was recently introduced as an effective treatment for MGD. We here evaluated the efficacy of IPL combined with MG expression (MGX) compared with MGX alone ( = 23 and 20, respectively) for patients with refractory ADDE with mild MGD at three sites. Symptom score, visual acuity (VA), noninvasive breakup time (NIBUT) and lipid layer thickness (LLT) of the tear film, lid margin abnormalities, fluorescein BUT (FBUT), fluorescein staining, tear meniscus height (TMH), meibum grade, meiboscore, and Schirmer's test value were assessed at baseline and 1 and 3 months after treatment. LLT, plugging, vascularity, FBUT and NIBUT were improved only in the IPL-MGX group at three months compared with baseline. All parameters with the exception of VA, meiboscore, TMH, Schirmer's test value were also improved in the IPL-MGX group compared with the control group at three months, as was VA in patients with central corneal epitheliopathy. Although IPL-MGX does not affect aqueous layer, the induced improvement in quality and quantity of the lipid layer may increase tear film stability and ameliorate symptoms not only for evaporative dry eye but for ADDE.
水液缺乏型干眼（ADDE）和睑板腺功能障碍（MGD）的治疗可能具有难治性。强脉冲光（IPL）最近被引入作为MGD的一种有效治疗方法。我们在此评估了IPL联合睑板腺表达（MGX）与单独使用MGX（分别为23例和20例）相比，对三个部位轻度MGD的难治性ADDE患者的疗效。在基线以及治疗后1个月和3个月时，评估症状评分、视力（VA）、泪膜的非侵入性泪膜破裂时间（NIBUT）和脂质层厚度（LLT）、睑缘异常、荧光素泪膜破裂时间（FBUT）、荧光素染色、泪河高度（TMH）、睑脂等级、睑板腺评分以及泪液分泌试验值。与基线相比，仅IPL - MGX组在3个月时LLT、堵塞情况、血管化程度、FBUT和NIBUT有所改善。与对照组相比，IPL - MGX组在3个月时除VA、睑板腺评分、TMH、泪液分泌试验值外的所有参数均有所改善，中央角膜上皮病变患者的VA也有所改善。尽管IPL - MGX不影响水液层，但诱导的脂质层质量和数量的改善可能会增加泪膜稳定性，不仅改善蒸发型干眼的症状，也改善ADDE的症状。
