Huo Yanan, Mo Yanping, Wu Yaying, Fang Fei, Jin Xiuming
Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Ophthalmology, Huzhou Third Municipal Hospital, Huzhou, China.
Ann Transl Med. 2021 Feb;9(3):238. doi: 10.21037/atm-20-1745.
To evaluate the therapeutic effect of intense pulsed light (IPL) therapy with optimal pulse technology (OPT) on meibomian gland dysfunction (MGD) with and without ocular infestation.
This prospective study included 150 patients with MGD who were divided into -infested (DI) and non-infested (control) groups according to counts determined by epilating eyelashes to evaluate. Each patient underwent three OPT treatment sessions at 3-week intervals. Best corrected visual acuity (BCVA), intraocular pressure (IOP), counts, Ocular Surface Disease Index (OSDI) score, conjunctival congestion, tear meniscus height (TMH), tear breakup time (TBUT), Schirmer I test (SIT), corneal and conjunctival fluorescein staining scores, meibomian gland (MG) macrostructure, lid margin abnormality, MG expressibility, and meibum quality were assessed before the first treatment as baseline and at 1, 2, and 3 months (M1, M2 and M3, respectively) after treatment.
The incidence of infestation was 59.15% (84/142) at baseline and the final eradication rate at M3 was 83.3% (70/84). Corneal staining and conjunctival congestion showed slower improvement in the DI group than in the control group at M1 and M2 (P<0.05), but was significantly improved at M3 than that at with baseline (P<0.01). Both the groups showed significant improvement in OSDI, conjunctival congestion, TBUT, corneal and conjunctival staining, MG dropout, lid margin abnormality, MG expressibility, and meibum quality at M3 (P<0.05). No differences were observed for BCVA, IOP, SIT, and TMH before and after treatment in both the groups (P>0.05).
This new-generation IPL with OPT treatment results in greater improvement in MG expressibility and meibum quality in MGD patients with infestation than in those without, but not for corneal staining.
评估采用优化脉冲技术(OPT)的强脉冲光(IPL)疗法对伴有和不伴有眼部螨虫感染的睑板腺功能障碍(MGD)的治疗效果。
这项前瞻性研究纳入了150例MGD患者,根据拔睫毛计数将其分为感染组(DI)和非感染组(对照组)进行评估。每位患者每隔3周接受3次OPT治疗。在首次治疗前作为基线以及治疗后1个月、2个月和3个月(分别为M1、M2和M3)评估最佳矫正视力(BCVA)、眼压(IOP)、螨虫计数、眼表疾病指数(OSDI)评分、结膜充血、泪膜半月板高度(TMH)、泪膜破裂时间(TBUT)、Schirmer I试验(SIT)、角膜和结膜荧光素染色评分、睑板腺(MG)宏观结构、睑缘异常、MG可表达性和睑脂质量。
基线时螨虫感染发生率为59.15%(84/142),M3时最终螨虫清除率为83.3%(70/84)。在M1和M2时,DI组角膜染色和结膜充血的改善比对照组慢(P<0.05),但在M3时比基线时显著改善(P<0.01)。两组在M3时OSDI、结膜充血、TBUT、角膜和结膜染色、MG缺失、睑缘异常、MG可表达性和睑脂质量均有显著改善(P<0.05)。两组治疗前后BCVA、IOP、SIT和TMH均无差异(P>0.05)。
采用OPT治疗新一代IPL,与未感染螨虫的MGD患者相比,感染螨虫的MGD患者的MG可表达性和睑脂质量改善更大,但对角膜染色无改善。