Kawagoe Tatsukata, Mizuki Yuki, Akaishi Miki, Takeuchi Masaki, Yabuki Kazuro, Hata Seiichiro, Meguro Akira, Mizuki Nobuhisa, Teshigawara Takeshi
Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan.
Department of Ophthalmology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan.
J Clin Med. 2025 Apr 18;14(8):2805. doi: 10.3390/jcm14082805.
This research seeks to investigate the effects of preoperative intense pulsed light with manual meibomian expression (IPL-MGX) on the refractive accuracy of cataract surgery on dry eyes with meibomian gland dysfunction (MGD-related dry eyes). Fifty-six MGD-related dry eye cases planned for cataract surgery were analyzed. IPL-MGX (four times at 2-week intervals) was performed before preoperative examination. Axial length (AL), anterior chamber depth (ACD), corneal curvature (mean-K), tear break-up time (TBUT), superficial punctate keratopathy in the central cornea (C-SPK), corneal higher-order aberrations (HOAs), and predicted postoperative spherical equivalent (P-SE) were evaluated pre- and post-IPL-MGX. The postoperative subjective spherical equivalent (S-SE) was evaluated after one month. The absolute difference between the S-SE and P-SE was considered an indication of P-SE accuracy. Changes in all the variables were assessed before and after IPL-MGX treatment. No significant differences were observed in AL or ACD ( = 0.85, 0.56). The differences in mean-K, TBUT, C-SPK, and HOAs were significant ( < 0.01). P-SE accuracy based on post-IPL-MGX data was significantly higher than that based on pre-IPL-MGX data ( < 0.01). P-SE accuracy was within 0.25 diopters (D) in 14.3% of pre- and 55.4% of post-IPL-MGX, within 0.5D in 55.4% of pre- and 92.9% of post-IPL-MGX, within 0.75D in 98.2% of pre- and post-IPL-MGX, and within 1.0D in 98.2% of pre- and 100% of post-IPL-MGX. In the range of 0.25 and 0.5 D, the accuracy of P-SE was significantly higher in post-IPL-MGX ( < 0.01). Preoperative IPL-MGX considerably improved the predicted postoperative refraction accuracy in patients with MGD-related dry eye undergoing cataract surgery.
本研究旨在探讨术前强脉冲光联合睑板腺按摩（IPL-MGX）对睑板腺功能障碍相关性干眼（MGD相关性干眼）患者白内障手术屈光准确性的影响。分析了56例计划行白内障手术的MGD相关性干眼病例。在术前检查前进行IPL-MGX（每隔2周进行4次）。评估IPL-MGX前后的眼轴长度（AL）、前房深度（ACD）、角膜曲率（平均K值）、泪膜破裂时间（TBUT）、中央角膜浅表点状角膜炎（C-SPK）、角膜高阶像差（HOAs）以及预测术后等效球镜度（P-SE）。术后1个月评估主观等效球镜度（S-SE）。S-SE与P-SE的绝对差值被视为P-SE准确性的指标。评估IPL-MGX治疗前后所有变量的变化。AL或ACD未观察到显著差异（P = 0.85，0.56）。平均K值、TBUT、C-SPK和HOAs的差异具有统计学意义（P < 0.01）。基于IPL-MGX后数据的P-SE准确性显著高于基于IPL-MGX前数据的准确性（P < 0.01）。IPL-MGX前14.3%、IPL-MGX后55.4%的P-SE准确性在0.25屈光度（D）以内；IPL-MGX前55.4%、IPL-MGX后92.9%的P-SE准确性在0.5D以内；IPL-MGX前后98.2%的P-SE准确性在0.75D以内；IPL-MGX前98.2%、IPL-MGX后100%的P-SE准确性在1.0D以内。在0.25至0.5D范围内，IPL-MGX后的P-SE准确性显著更高（P < 0.01）。术前IPL-MGX显著提高了MGD相关性干眼白内障手术患者的术后预测屈光准确性。
