Peng Kai-Ling, Chiu Chen-Jui, Tuan Hsin-I, Lee Yi-Chen, Hsu Pyn-Sing, Chen Jiunn-Liang
Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan.
Life (Basel). 2022 Jul 20;12(7):1086. doi: 10.3390/life12071086.
Dry eye disease (DED) is most commonly caused by evaporative subtypes and mainly induced by meibomian gland dysfunction (MGD). Intense pulsed light (IPL) combined with meibomian gland expression (MGX) is a noninvasive treatment for improvement of ocular discomfort symptoms and MGD. In this prospective study between November 2020 and May 2022, the patients with MGD and abnormal meibomian expressibility that met the criteria of both ocular surface disease index (OSDI) ≥ 13 scores and standardized patient evaluation of eye dryness (SPEED) ≥ 8 scores were enrolled in Kaohsiung Veteran General Hospital. Three separate treatment sessions of IPL therapy combined with MGX were administered to the lower lids, with an interval of 28 days. Further tear film assessment included lipid layer thickness (LLT), tear meniscus height (TMH), noninvasive tear break-up time (NIBUT), and meibomian gland loss (MGL) either before or after first and third IPL therapy combined with MGX. In addition, lissamine green staining and pain scores were also recorded. We totally enrolled 37 patients of 74 eyes. Men accounted for 18.92% (7/37). The mean age was 54.51 ± 11.72 years. The mean OSDI scores were 58.12 ± 22, while the SPEED scores were 17.03 ± 5.98. The mean Schirmer’s test was 3.66 ± 2.43 mm. After three sessions of IPL treatment with MGX, the OSDI, SPEED, LLT, TMH, MGL, MGXS, and pain scores were significantly improved. For the MGX scores (MGXS) ≤ 20 group, lissamine green scores showed nearly significant improvements. For the MGXS > 20 group, TMH revealed statistical improvement. Noninvasive IPL therapy with MGX statistically improved not only dry eye symptoms, but also tear film assessments, including LLT, TMH, and MGL.
干眼疾病（DED）最常见的病因是蒸发型亚型，主要由睑板腺功能障碍（MGD）引起。强脉冲光（IPL）联合睑板腺挤压（MGX）是一种用于改善眼部不适症状和MGD的非侵入性治疗方法。在这项于2020年11月至2022年5月期间开展的前瞻性研究中，符合眼表疾病指数（OSDI）≥13分且标准化干眼患者评估（SPEED）≥8分标准的MGD及睑板腺可挤压性异常患者被纳入高雄荣民总医院的研究。对下眼睑进行了三次单独的IPL治疗联合MGX治疗，间隔为28天。进一步的泪膜评估包括在首次和第三次IPL治疗联合MGX之前或之后的脂质层厚度（LLT）、泪河高度（TMH）、非侵入性泪膜破裂时间（NIBUT）和睑板腺缺失（MGL）。此外，还记录了丽丝胺绿染色和疼痛评分。我们共纳入了37例患者的74只眼。男性占18.92%（7/37）。平均年龄为54.51±11.72岁。平均OSDI评分为58.12±22，而SPEED评分为17.03±5.98。平均泪液分泌试验为3.66±2.43毫米。经过三次IPL联合MGX治疗后，OSDI、SPEED、LLT、TMH、MGL、MGX评分（MGXS）和疼痛评分均有显著改善。对于MGXS≤20分组，丽丝胺绿评分显示出近乎显著的改善。对于MGXS>20分组，TMH显示出统计学上的改善。IPL联合MGX的非侵入性治疗不仅在统计学上改善了干眼症状，还改善了泪膜评估指标，包括LLT、TMH和MGL。
