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强脉冲光和睑板腺按摩治疗睑板腺功能障碍的疗效:一项随机对照试验的荟萃分析。

Efficacy of intense pulsed light and meibomian gland expression treatments in meibomian gland dysfunction: A meta-analysis of randomized controlled trials.

机构信息

Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China.

出版信息

Medicine (Baltimore). 2022 Dec 23;101(51):e32292. doi: 10.1097/MD.0000000000032292.

Abstract

PURPOSE

This review aimed to evaluate the efficacy and safety of intense pulsed light treatment combined with meibomian gland expression treatments in meibomian gland dysfunction.

METHODS

We conducted a meta-analysis of randomized controlled trials that compared the efficacy of intense pulsed light treatment and meibomian gland expression treatments in the treatment of dry eye disease. The meibomian gland yielding secretion score was the primary outcome, whereas the secondary outcomes included the Meiboscore, tear breakup time in seconds, standard patient evaluation for eye dryness and corneal fluorescein staining.

RESULTS

This study consisted of 6 trials with 326 patients. Significantly greater improvement was observed in meibomian gland yielding secretion score at 1 month [mean difference (MD): 13.69 (95% CI, 11.98, 15.40)] and at 3 months [MD: 11.03 (95% confidence interval (CI), 10.27, 11.80)], low meibomian gland yielding secretion score at 1 month [MD: 6.92 (95% CI, 5.49, 8.34)] and at 3 months [MD: 6.80 (95% CI, 5.01, 8.59)], up meibomian gland yielding secretion score at 1 month [MD: 6.41 (95% CI, 4.12, 8.70)] and at 3 months [MD: 8.06 (95% CI, 5.70, 10.42)] and tear breakup time at 1 month [MD: 2.38 (95% CI, 1.83, 2.92)] and at 3 months [MD: 1.82 (95% CI, 1.48, 2.19)] in the IPL-MGX group than in the MGX group.

CONCLUSIONS

IPL-MGX is safer and more efficacious as compared to the MGX alone in the treatment of patients with meibomian gland dysfunction-related dry eye. We recommend discussing the decision with the ophthalmologist for an appropriate choice.

摘要

目的

本综述旨在评估强脉冲光(IPL)联合睑板腺按摩(MGX)治疗睑板腺功能障碍的疗效和安全性。

方法

我们对比较 IPL 治疗与 MGX 治疗干眼症的随机对照试验进行了荟萃分析。主要结局为睑板腺分泌物排出评分,次要结局包括 Meiboscore、泪膜破裂时间(tear breakup time,简写为 BUT)、标准干眼患者评估和角膜荧光素染色。

结果

本研究共纳入 6 项试验,共 326 例患者。1 个月时,MGX 联合 IPL 组在睑板腺分泌物排出评分方面的改善明显更优[平均差值(mean difference,MD):13.69(95%置信区间,11.9815.40)],3 个月时仍如此[MD:11.03(95%置信区间,10.2711.80)];1 个月时低睑板腺分泌物排出评分组[MD:6.92(95%置信区间,5.498.34)]和 3 个月时[MD:6.80(95%置信区间,5.018.59)]、1 个月时高睑板腺分泌物排出评分组[MD:6.41(95%置信区间,4.128.70)]和 3 个月时[MD:8.06(95%置信区间,5.7010.42)]、1 个月时 BUT 组[MD:2.38(95%置信区间,1.832.92)]和 3 个月时[MD:1.82(95%置信区间,1.482.19)]均明显优于 MGX 组。

结论

与 MGX 单独治疗相比,MGX 联合 IPL 治疗睑板腺功能障碍相关干眼症更安全、更有效。我们建议与眼科医生讨论该决定,以做出适当选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4dc/9794218/301d3af77dc9/medi-101-e32292-g001.jpg

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