Lu Chuwei, Han Danjie, Zeng Li, Hong Jiaxu, Fadel Daddi, Zhou Xingtao, Chen Zhi, Le Qihua
Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China.
NHC Key laboratory of Myopia and Related Eye Diseases, Shanghai 200031, China.
J Clin Med. 2025 Jan 21;14(3):658. doi: 10.3390/jcm14030658.
Scleral lenses (SLs) are recommended in DEWS II to treat dry eye (DE) patients that do not respond well to conventional therapies. This study aimed to evaluate the short-term (one month) efficacy and safety of SLs in the management of severe DE. This single-center prospective study enrolled 15 patients (22 eyes) who were diagnosed with severe DE. The Ocular Surface Disease Index (OSDI), the Chinese version of the 25-item National Eye Institute Visual Function Questionnaire (CHI-VFQ-25), and LogMAR best-corrected visual acuity (BCVA) were evaluated at baseline and one month following SL fitting. DE-related parameters were obtained and analyzed before and after one month of SL treatment, including tear-film breakup time (TBUT), corneal fluorescein staining (CFS), non-invasive breakup time (NIBUT), tear meniscus height (TMH), Schirmer I test (SIT), and meibomian gland (MG) dropout. Complications and adverse events were monitored. OSDI scores (53.9 ± 28.1 vs. 10.4 (4.2-25), = 0.0001) and CFS scores (10.2 ± 3.9 vs. 7 (0-12), = 0.001) decreased after one month of SL therapy, while CHI-VFQ-25 scores (74.4 (54.8-83.8) vs. 95 (78.7-98), = 0.0001) and TBUT (0.6 ± 0.5 vs. 2.2 ± 1.0, < 0.0001) increased significantly. LogMAR BCVA improved from 0 (0-0.1) to 0 (0-0) ( = 0.0147). The average types of medications per eye decreased from 2.82 ± 1.01 to 1.32 ± 0.64 ( 0.025), and the proportion of eyes using glucocorticoids significantly decreased from 63.6% to 13.6% ( 0.001). No severe SL-related adverse events were reported. SL treatment quickly alleviated subjective symptoms as well as clinical signs of DE with good safety and enhanced the visual function and vision-related quality of life, showing its usefulness in the management of severe DE.
在《干眼综合征研究进展（二）》（DEWS II）中推荐使用巩膜镜（SLs）来治疗对传统疗法反应不佳的干眼（DE）患者。本研究旨在评估巩膜镜在重度干眼治疗中的短期（一个月）疗效和安全性。这项单中心前瞻性研究纳入了15例（22只眼）被诊断为重度干眼的患者。在巩膜镜验配前及验配后一个月评估眼表疾病指数（OSDI）、中文版25项美国国立眼科研究所视觉功能问卷（CHI-VFQ-25）以及LogMAR最佳矫正视力（BCVA）。在巩膜镜治疗一个月前后获取并分析与干眼相关的参数，包括泪膜破裂时间（TBUT）、角膜荧光素染色（CFS）、非侵入性泪膜破裂时间（NIBUT）、泪河高度（TMH）、Schirmer I试验（SIT）以及睑板腺（MG）缺失情况。监测并发症和不良事件。巩膜镜治疗一个月后，OSDI评分（53.9±28.1对比10.4（4.2 - 25），P = 0.0001）和CFS评分（10.2±3.9对比7（0 - 12），P = 0.001）降低，而CHI-VFQ-25评分（74.4（54.8 - 83.8）对比95（78.7 - 98），P = 0.0001）和TBUT（0.6±0.5对比2.2±1.0，P < 0.0001）显著升高。LogMAR BCVA从0（0 - 0.1）改善至0（0 - 0）（P = 0.0147）。每只眼平均用药种类从2.82±1.01降至1.32±0.64（P = 0.025），使用糖皮质激素的眼的比例从63.6%显著降至13.6%（P = 0.001）。未报告与巩膜镜相关的严重不良事件。巩膜镜治疗能迅速缓解重度干眼的主观症状和临床体征，安全性良好，并能改善视觉功能和与视力相关的生活质量，显示出其在重度干眼治疗中的有效性。
