From the Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, Florence, Italy.
J Cataract Refract Surg. 2023 Apr 1;49(4):423-429. doi: 10.1097/j.jcrs.0000000000001124.
To evaluate the effect of a single LipiFlow vector thermal pulsation treatment performed before cataract surgery in reducing signs and symptoms of postoperative dry eye disease (DED) in patients with mild-moderate meibomian gland dysfunction (MGD).
Eye Clinic, Careggi Hospital, University of Florence, Florence, Italy.
Prospective unmasked randomized controlled clinical trial.
This study included patients affected by age-related cataract and mild-moderate MGD, who were randomized into 2 groups: (1) a single LipiFlow treatment performed at 5 preoperative weeks and (2) warm compresses and eyelid massages twice a day for 1 preoperative month (control group). Noninvasive break-up time (NI-BUT), Schirmer test, Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and MG functionality parameters were evaluated at visit 0 (5 preoperative weeks), visit 1 (1 preoperative week), and visit 2 (1 postoperative month). Confocal microscopy of the MG of lower eyelids was performed at visit 0 and visit 2.
A total of 46 patients (46 eyes) were enrolled. In the LipiFlow group (n = 23), NI-BUT, SPEED questionnaire, and MG functionality parameters significantly improved at visit 1 ( P < .05) and visit 2 ( P < .05) compared with baseline and remained stable postoperatively. In the control group (n = 23), they did not significantly improve after treatment, while worsened postoperatively. Moreover, the changes in all parameters from baseline were significantly different between the 2 groups. Confocal microscopy imaging highlighted lower postoperative MG alterations in the LipiFlow group.
A single preoperative LipiFlow treatment was effective in preventing postcataract surgery DED in patients with mild-moderate MGD. Postoperatively, treated patients displayed a better ocular surface status compared with warm compresses.
评估白内障术前单次 LipiFlow 向量热脉动治疗对改善轻中度睑板腺功能障碍（MGD）患者术后干眼症状（DED）的效果。
意大利佛罗伦萨 Careggi 医院眼科诊所。
前瞻性非盲随机对照临床试验。
本研究纳入了年龄相关性白内障合并轻中度 MGD 的患者，将其随机分为 2 组：（1）术前 5 周行单次 LipiFlow 治疗；（2）术前 1 个月行每日 2 次热敷和眼睑按摩（对照组）。在访视 0（术前 5 周）、访视 1（术前 1 周）和访视 2（术后 1 个月）时评估非侵入性泪膜破裂时间（NI-BUT）、泪液分泌试验、标准干眼患者评估（SPEED）问卷和 MG 功能参数。在访视 0 和访视 2 时对下眼睑的 MG 进行共焦显微镜检查。
共纳入 46 例患者（46 只眼）。在 LipiFlow 组（n = 23）中，NI-BUT、SPEED 问卷和 MG 功能参数在访视 1（P <.05）和访视 2（P <.05）时与基线相比显著改善，术后保持稳定。在对照组（n = 23）中，治疗后这些参数没有显著改善，反而在术后恶化。此外，2 组间各项参数从基线的变化差异均有统计学意义。共焦显微镜成像显示 LipiFlow 组术后 MG 改变较小。
术前单次 LipiFlow 治疗可有效预防轻中度 MGD 患者白内障术后 DED。术后，与热敷相比，治疗组患者的眼表状况更好。
