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影响强脉冲光治疗睑板腺功能障碍临床效果的因素。

Factors influencing the clinical outcomes of intense pulsed light for meibomian gland dysfunction.

机构信息

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Medicine (Baltimore). 2021 Dec 10;100(49):e28166. doi: 10.1097/MD.0000000000028166.

Abstract

To observe the clinical outcomes of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and identify its influencing factors.Forty-eight eyes of 48 patients with MGD were included. Subjects were followed up 5 times on day 1, day 15, day 30, day 45, and day 120, and underwent 3 sessions of the IPL treatment on day 1, day 15 and day 30. Gender, age, duration of MGD, time of video display terminal usage, and severity of MGD were recorded at baseline. At every visit, Ocular Surface Disease Index (OSDI), eyelid margin abnormality score, tear film breakup time, Schirmer I test (S ɪ t) and corneal fluorescein staining were recorded. The clinical parameters before and after 3 IPL treatments were compared. Univariate and multivariable logistic regression analyses were performed to explore influencing factors.Compared with baseline, the tear film breakup time was increased and the corneal fluorescein staining score and OSDI were significantly decreased on day 45 and day 120 (all P < .001). In univariate analysis, among the patients with a younger age (18-39 years), moderate MGD, higher baseline S ɪ t and higher baseline OSDI, the IPL treatment had a higher effective rate (P = .032, .004, .024, and .014 respectively). The MGD severity was strongly associated with effective IPL, and patients with moderate MGD had an OR of 22.454 compared with the severe MGD patients (OR = 22.454, 95% CI: 2.890-174.436, P = .003).IPL effectively improves clinical symptoms and some signs in MGD patients. Age, MGD severity, baseline S ɪ t and baseline OSDI are potential factors that may influence the clinical outcomes of IPL. MGD severity is an independent influencing factor.

摘要

观察强脉冲光(IPL)治疗睑板腺功能障碍(MGD)的临床疗效,并分析其影响因素。

纳入 48 例(48 眼)MGD 患者,于第 1、15、30、45 和 120 天随访,第 1、15 和 30 天进行 3 次 IPL 治疗。记录患者的性别、年龄、MGD 病程、视频显示终端使用时间、MGD 严重程度等一般资料。于治疗前及治疗后第 45 天和 120 天记录患者眼表疾病指数(OSDI)、睑缘异常评分、泪膜破裂时间(BUT)、泪液分泌试验(Sit)和角膜荧光素染色评分。比较 IPL 治疗前后各项临床参数的变化,并采用单因素和多因素 logistic 回归分析探讨影响 IPL 疗效的因素。

与治疗前相比,患者在治疗后第 45 天和 120 天的 BUT 延长,角膜荧光素染色评分和 OSDI 降低(均 P < 0.001)。单因素分析显示,年龄 18~39 岁、中重度 MGD、基线 Sit 较高和基线 OSDI 较高的患者,IPL 治疗有效率较高(P = 0.032、0.004、0.024、0.014)。MGD 严重程度与 IPL 疗效密切相关,中重度 MGD 患者的 IPL 治疗有效率是重度 MGD 患者的 22.454 倍(OR = 22.454,95%CI:2.890~174.436,P = 0.003)。

IPL 可有效改善 MGD 患者的临床症状和体征,年龄、MGD 严重程度、基线 Sit 和基线 OSDI 是影响 IPL 疗效的潜在因素,MGD 严重程度是独立影响因素。

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