Zhai Zimeng, Jiang Hao, Wu Yuqing, Yang Pei, Zhou Shuyun, Hong Jiaxu
Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai 200031, China.
Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.
J Clin Med. 2022 May 30;11(11):3080. doi: 10.3390/jcm11113080.
To explore the safety and feasibility of low fluence intense pulsed light (IPL) for treating pediatric patients with moderate-to-severe blepharitis and to analyze potential factors associated with the recovery of meibomian glands (MG) dropout, a retrospective, noncomparative study, including 17 blepharitis patients (33 eyes) aged between 5 and 16 years old was conducted. All of the participants were given 4 continuous sessions of low-fluence (9−12 J/cm2) IPL at 3−4 week intervals. Corneal fluorescein staining (CFS), tear breakup time (BUT), inferior tear meniscus height, Demodex presence, and MG morphology were examined before and after the treatment. Results indicated that CFS, BUT and MG morphology (central/total gland area ratio and gland signal index) had significantly improved (p < 0.05). Symptoms and signs such as severe corneal neovascularization, limbal pannus and conjunctival congestion also subsided. Among age, gender, presence of Demodex and interval before diagnosis, age initiating the formal treatment was confirmed as a negatively correlated factor of the recovery of MG dropout (p = 0.032, B = −1.755). No notable adverse events were reported. In conclusion, low fluence IPL seems to be a safe and effective alternative for moderate-to-severe pediatric blepharitis, and MG dropout is prone to recover in younger patients.
为探讨低能量强脉冲光（IPL）治疗中重度睑缘炎患儿的安全性和可行性，并分析与睑板腺（MG）缺失恢复相关的潜在因素，开展了一项回顾性、非对照研究，纳入了17例年龄在5至16岁之间的睑缘炎患者（33只眼）。所有参与者均接受连续4次低能量（9−12 J/cm2）IPL治疗，间隔3至4周。在治疗前后检查角膜荧光素染色（CFS）、泪膜破裂时间（BUT）、下方泪河高度、蠕形螨感染情况和MG形态。结果表明，CFS、BUT和MG形态（中央/腺体总面积比和腺体信号指数）有显著改善（p < 0.05）。严重角膜新生血管、角膜缘血管翳和结膜充血等症状和体征也有所减轻。在年龄、性别、蠕形螨感染情况和诊断前间隔时间中，开始正规治疗的年龄被确认为MG缺失恢复的负相关因素（p = 0.032，B = −1.755）。未报告明显不良事件。总之，低能量IPL似乎是治疗中重度小儿睑缘炎的一种安全有效的替代方法，且MG缺失在年轻患者中更容易恢复。
