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强脉冲光对蒸发性干眼症患者前角膜像差和视觉质量的影响。

Effect of Intense Pulsed Light on Anterior Corneal Aberrations and Quality of Vision in Patients with Evaporative Dry Eye.

机构信息

He Eye Specialist Hospital, Shenyang, China.

The Second Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Photobiomodul Photomed Laser Surg. 2021 Mar;39(3):185-195. doi: 10.1089/photob.2020.4953. Epub 2021 Feb 23.

Abstract

To evaluate the improvement in the tear film lipid layer (TFLL) and its subsequent impact upon corneal aberrations following intense pulsed light (IPL) treatment in patients with evaporative dry eye disease (DED) due to meibomian gland dysfunction (MGD). The prevalence of DED is common and can lead to ocular discomfort, reduced visual acuity, and lowered quality of vision (QoV) and life. In this self-control study, patients with moderate-to-severe evaporative DED due to MGD were consecutively enrolled and underwent two IPL treatments at 3-week intervals. Clinical assessments, such as Ocular Surface Disease Index (OSDI) and QoV questionnaires, anterior corneal aberrations, noninvasive tear breakup time (NITBUT), interferometric fringe pattern as determined by TFLL quality, corneal fluorescein staining (CFS), meibum gland (MG), conjunctival hyperemia (CH), best-corrected visual acuity, endothelial cell count, and intraocular pressure, were conducted at pretreatment (D-0), day 21 (D-21), and day 42 (D-42) after IPL treatment. The final analysis included 124 eyes of 62 patients (29 females, 33 males; mean age 35.66 ± 11.09 years). Clinically and statistically significant improvement in NITBUT was observed at D-42 ( < 0.01). OSDI, QoV, TFLL score, and MG quality and expressibility all improved significantly ( < 0.05) at D-42, whereas CH ( = 0.073) and CFS ( = 0.058) showed minor not significant improvements at D-42 of assessment. Anterior corneal aberrations also improved significantly at D-42 of assessment ( < 0.05). IPL treatment reduced the severity of symptoms and improved the overall tear film (TF) stability in patients with moderate-to-severe evaporative dry eye (DE) due to MGD. Additionally, the significant improvement in QoV in DE patients can be attributed to the reduction in anterior corneal aberrations due to improved TF stability.

摘要

评估强脉冲光 (IPL) 治疗睑板腺功能障碍 (MGD) 引起的蒸发性干眼症 (DED) 患者的泪膜脂质层 (TFLL) 改善及其对角膜像差的后续影响。DED 的患病率较高,可导致眼部不适、视力下降以及视觉质量 (QoV) 和生活质量下降。在这项自身对照研究中,连续招募了中重度 MGD 引起的蒸发性 DED 患者,并在 3 周间隔内进行了两次 IPL 治疗。临床评估,如眼表疾病指数 (OSDI) 和 QoV 问卷、前角膜像差、非侵入性泪膜破裂时间 (NITBUT)、通过 TFLL 质量确定的干涉条纹模式、角膜荧光素染色 (CFS)、睑板腺 (MG)、结膜充血 (CH)、最佳矫正视力、内皮细胞计数和眼压,在治疗前 (D-0)、治疗后第 21 天 (D-21) 和第 42 天 (D-42) 进行。最终分析包括 62 例患者的 124 只眼 (29 名女性,33 名男性;平均年龄 35.66±11.09 岁)。在 D-42 时观察到 NITBUT 有临床和统计学意义的改善 ( < 0.01)。OSDI、QoV、TFLL 评分以及 MG 的质量和表达均在 D-42 时显著改善 ( < 0.05),而 CH ( = 0.073) 和 CFS ( = 0.058) 在评估的 D-42 时仅有轻微但无统计学意义的改善。前角膜像差在评估的 D-42 时也有显著改善 ( < 0.05)。IPL 治疗可减轻 MGD 引起的中重度蒸发性干眼症患者的症状严重程度,并改善总体泪膜 (TF) 稳定性。此外,DE 患者 QoV 的显著改善可归因于 TF 稳定性的提高导致前角膜像差的减少。

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