Department of Ophthalmology, He Eye Specialist Hospital, Shenyang, China.
The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Photobiomodul Photomed Laser Surg. 2022 Mar;40(3):189-197. doi: 10.1089/photob.2021.0094.
Contact lens-related dry eye (CLDE) is common in contact lens (CL) wearers and can lead to ocular pain, decreased visual quality, and reduced quality of life. The purpose of this prospective, randomized, examiner masked study was to compare the effectiveness of intense pulsed light (IPL) and heated eye mask (HEM) for relieving CLDE. The final analysis included 60 patients (30 in the IPL group and 30 in the HEM group) who were using CL and had been suffering contact lens discomfort for more than a year. The IPL treatment group had two IPL treatments spaced 3 weeks apart, whereas the HEM group received HEM daily for 6 weeks (42 days). Non-invasive tear break-up time (NITBUT), tear-film lipid layer (TFLL), conjunctival fluorescein staining, meibum gland quality and expression, conjunctival redness score, ocular surface disease index (OSDI), best-corrected visual acuity, endothelial cell count, and intraocular pressure were assessed at baseline: first visit (V1), second visit (V2), and third visit (V3). The mean age of the IPL group was 28.6 ± 4.3 years (16 females, 53%) and that of the HEM group was 28.6 ± 4.2 years (16 females, 53%). Mean NITBUT for the IPL group at V2 was 5.53 ± 0.77 sec ( < 0.001) and at V3 was 7.72 ± 0.88 sec ( < 0.001); the IPL group demonstrated a clinically and statistically significant improvement in mean NITBUT. In addition, the HEM group showed a clinically and statistically significant improvement in mean NITBUT at V3 (5.86 ± 0.76 sec, < 0.001). At V3, the C-OSDI, TFLL score, and meibum gland quality and expressibility all increased considerably ( < 0.05) in both groups. Our results imply that IPL or HEM treatment of CLDE can be safely used to relieve symptoms of CLDE. In addition, IPL treatment is more effective in improving the general stability of the tear-film and decreasing the need for artificial tears in CLDE.
接触镜相关干眼（CLDE）在接触镜（CL）佩戴者中很常见，可导致眼部疼痛、视觉质量下降和生活质量降低。本前瞻性、随机、检查者盲法研究的目的是比较强脉冲光（IPL）和加热眼罩（HEM）治疗 CLDE 的效果。最终分析纳入了 60 名患者（IPL 组 30 名，HEM 组 30 名），他们均使用接触镜，且接触镜不适症状已持续 1 年以上。IPL 治疗组接受 2 次 IPL 治疗，间隔 3 周；HEM 组接受 HEM 治疗，每天 1 次，共 6 周（42 天）。分别在基线、第 1 次就诊（V1）、第 2 次就诊（V2）和第 3 次就诊（V3）评估非侵入性泪膜破裂时间（NITBUT）、泪膜脂质层（TFLL）、结膜荧光素染色、睑板腺质量和分泌、结膜充血评分、眼表疾病指数（OSDI）、最佳矫正视力、内皮细胞计数和眼压。IPL 组的平均年龄为 28.6±4.3 岁（16 名女性，占 53%），HEM 组的平均年龄为 28.6±4.2 岁（16 名女性，占 53%）。V2 时，IPL 组的平均 NITBUT 为 5.53±0.77 秒（ < 0.001），V3 时为 7.72±0.88 秒（ < 0.001）；IPL 组的平均 NITBUT 显著改善，具有临床和统计学意义。此外，HEM 组在 V3 时的平均 NITBUT 也有显著改善（5.86±0.76 秒， < 0.001）。V3 时，两组的 C-OSDI、TFLL 评分以及睑板腺质量和分泌均有显著改善（ < 0.05）。我们的结果表明，CLDE 的 IPL 或 HEM 治疗可安全用于缓解 CLDE 的症状。此外，IPL 治疗在改善泪膜整体稳定性和减少 CLDE 对人工泪液的需求方面更为有效。
