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[为白内障手术治疗的干眼患者做准备时的眼睑卫生]

[Eyelid hygiene in preparing dry eye patients for cataract surgical treatment].

作者信息

Sakhnov S N, Yanchenko S V, Malyshev A V, Dashina V V, Karapetov G Yu, Sergienko A A, Zakaraya T G

机构信息

Kuban State Medical University, Krasnodar, Russia.

Krasnodar branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Krasnodar, Russia.

出版信息

Vestn Oftalmol. 2020;136(6. Vyp. 2):177-182. doi: 10.17116/oftalma2020136062177.

Abstract

PURPOSE

To evaluate the effectiveness of complex treatment, including eyelid hygiene, on the condition of ocular surface in dry eye patients before cataract surgery.

MATERIAL AND METHODS

The study included 56 female age-related cataract patients (64±4.3 years old) with dry eye caused by Meibomian gland dysfunction (MGD). The main group patients (=28) underwent eyelid hygiene therapy (2 times a day, 1 month) that involved Blefarogel cleansing, Blefarolotion, Blefarogel-1. The main and control (=28) group patients performed (during the month): «fat-water» type nanoemulsion instillation (3 times a day); preservative free vitamin-A application (at night). Methods included dry eye symptoms assessment (OSDI scale); TBUT; Shirmer-1 test; lissamine green vital staining with xerosis indicator calculation (van Bijsterveld scale); "lid wipers" symptom evaluation; Norn compression test. Statistical evaluation included: mean and standard deviation calculation (); significance of differences assessment (Mann-Whitney -test; Wilcoxon's T-test).

RESULTS

The main group patients (artificial tear, keratoprotection, eyelid hygiene) showed a statistically significant more pronounced decrease in OSDI (from 33.2±3.1 points to 15.2±1.8 points) and a significantly more pronounced increase in TBUT (from 4.8±0.5 s to 6.9±0.4 s) than in control group patients (artificial tear, keratoprotection; respectively, from 32.7±3.2 to 20.8±3.1 points and from 4.85±0.5 to 5.8±0.4 s; <0.05). Apparently, this was associated with a significantly more pronounced relief of the MGD signs in main group patients (from 2.1±0.1 to 1.1±0.2 points; <0.05) as a result of eyelid hygiene. In the control group, the dynamics of MGD severity (from 2.08±0.3 to 2.11±0.5 points) was statistically insignificant.

CONCLUSION

Eyelid hygiene (based on Blefarogel cleansing, Blefarolotion, Blefarogel-1) increases the effectiveness of dry eye treatment in MGD patients, compared with isolated tear substitution and keratoprotection.

摘要

目的

评估包括眼睑清洁在内的综合治疗对白内障手术前干眼症患者眼表状况的有效性。

材料与方法

该研究纳入了56名年龄相关性白内障女性患者(64±4.3岁),其干眼症由睑板腺功能障碍(MGD)引起。主要组患者(n = 28)接受眼睑清洁治疗(每天2次,持续1个月),包括使用Blefarogel清洁、Blefarolotion、Blefarogel - 1。主要组和对照组患者(n = 28)在一个月内进行:“油水”型纳米乳剂滴眼(每天3次);无防腐剂维生素A涂抹(夜间)。方法包括干眼症症状评估(OSDI量表);泪膜破裂时间(TBUT);Schirmer - 1试验;丽丝胺绿活体染色并计算干燥症指标(范·比斯特维尔德量表);“睑缘擦拭”症状评估;诺恩挤压试验。统计评估包括:计算均值和标准差();评估差异的显著性(曼 - 惠特尼U检验;威尔科克森T检验)。

结果

主要组患者(人工泪液、角膜保护、眼睑清洁)与对照组患者(人工泪液、角膜保护)相比,OSDI有统计学显著更明显的下降(从33.2±3.1分降至15.2±1.8分),TBUT有统计学显著更明显的增加(从4.8±0.5秒增至6.9±0.4秒)(分别从32.7±3.2降至20.8±3.1分,从4.85±0.5增至5.8±0.4秒;P<0.05)。显然,这与主要组患者因眼睑清洁使MGD体征明显更显著缓解有关(从2.1±0.1降至1.1±0.2分;P<0.05)。在对照组中,MGD严重程度的变化(从2.08±0.3至2.11±0.5分)无统计学意义。

结论

与单纯的泪液替代和角膜保护相比,眼睑清洁(基于Blefarogel清洁、Blefarolotion、Blefarogel - 1)可提高MGD患者干眼症治疗的有效性。

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