From UCSD School of Medicine Department of Ophthalmology, Shiley Eye Institute, La Jolla, CA, USA.
Sci Rep. 2024 Sep 27;14(1):22287. doi: 10.1038/s41598-024-72320-3.
To compare two types of lipid expression procedures to treat dry eye disease. Standardized treatment and evaluation methods were used in patients treated with either manual thermoelectric lipid expression (MiBoFlo) or automated lipid expression (Lipiflow) of the Meibomian glands. This was a contemporaneous, non-randomized study of both treatment methods. Treatment was per the manufacturers' recommendation. The primary outcome included two types of dry eye questionnaires as well as objective analysis of ocular surface including tear break up time, Schirmer testing, Osmolarity, and fluorescein staining. Baseline characteristics analyzed included floppy lid, conjunctivochalasis and lagophthalmos. Statistical analysis was performed correcting for baseline factors such as age and co existing pathology using multivariable analysis. Both treatments improved the results of the OSDI and SPEED dry eye questionnaire results. Both treatments resulted in improvement of many objective findings including SPK, lissamine green staining and tear break up time with the MiBoFlo showing more improvement than Lipiflow. OSDI was more sensitive to improvement of symptoms than the SPEED questionnaire. Manual expression with MiBoFlo device resulted in statistically more improvement in questionnaire scores than did automated expression with Lipiflow. Negative prognostic factors for symptomatic improvement included blepharitis, autoimmune disease and ocular allergies. Thermal lid therapy along with mechanical expression of lipids from the meibomian glands successfully treats dry eye symptoms and signs. Manual therapy with MiBoFlo resulted in more subjective and objective improvement scores than automated therapy with the Lipiflow device.
比较两种治疗干眼症的脂质表达方法。采用标准化治疗和评估方法，对接受手动热电脂质表达（MiBoFlo）或自动脂质表达（Lipiflow）治疗的患者的睑板腺进行治疗。这是两种治疗方法的同期、非随机研究。治疗方法按制造商的建议进行。主要结局包括两种干眼症问卷以及眼表的客观分析，包括泪膜破裂时间、泪液分泌试验、渗透压和荧光素染色。分析的基线特征包括眼睑松弛、结膜松弛和睑裂闭合不全。使用多变量分析校正年龄和并存病理等基线因素后，对统计学分析进行校正。两种治疗方法均改善了 OSDI 和 SPEED 干眼问卷结果。两种治疗方法均改善了许多客观发现，包括 SPK、丽丝胺绿染色和泪膜破裂时间，MiBoFlo 的改善程度优于 Lipiflow。OSDI 对症状改善的敏感性高于 SPEED 问卷。MiBoFlo 设备的手动表达在问卷评分方面的改善程度明显高于 Lipiflow 的自动表达。症状改善的负面预测因素包括睑缘炎、自身免疫性疾病和眼部过敏。热盖治疗联合机械性睑板腺脂质表达成功治疗干眼症状和体征。MiBoFlo 的手动治疗比 Lipiflow 设备的自动治疗在主观和客观改善评分方面更有效。
