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强脉冲光疗法改善隐形眼镜不适的体征和症状。

Intense pulsed light therapy to improve signs and symptoms of contact lens discomfort.

作者信息

Dumpati Srikanth, Iqbal Fatima, Vijay Ajay Kumar, Tan Jacqueline, Kumar Mukesh, Willcox Mark

机构信息

School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia.

School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia.

出版信息

Cont Lens Anterior Eye. 2025 Aug 11:102486. doi: 10.1016/j.clae.2025.102486.

Abstract

PURPOSE

To evaluate the effects of Intense Pulsed Light (IPL) therapy on signs and symptoms of Contact Lens Discomfort (CLD) in symptomatic contact lens (CL) wearers.

METHODS

A prospective, randomised, double masked study was conducted on 36 eyes of 18 CL wearers (IPL: n = 20; sham: n = 16) with a Contact Lens Dry Eye Questionnaire (CLDEQ-8) score ≥ 12. Participants received two IPL/sham treatments at three weeks intervals as per randomization. The sham group underwent simulated light exposure using a torch while the IPL device remained inactive. Meibomian gland expression was performed for both groups after each treatment. Symptom and clinical assessments included CLDEQ-8 questionnaire, non-invasive tear breakup time (NITBUT), tear film lipid layer thickness (TFLLT), tear meniscus height (TMH), tear volume, meibomian gland secretion score (MGSS), meiboscore (upper/lower eye lids), MG capping, pouting, foam, telangiectasia, hyperaemia (bulbar, limbal, & palpebral), palpebral roughness, corneal staining, and lid-parallel conjunctival folds (LIPCOF). Assessments were evaluated prior to treatment at baseline (D-0), and then at day 21(D-21), D-42, and D-90.

RESULTS

The IPL group showed a significant reduction in CLDEQ-8 score from 18.1 ± 1.9 at D-0 to 10.7 ± 1.1 at D-42 (p = 0.01), and improved meibomian gland secretion score (MGSS) at D-21 (p = 0.02) and D-42 (p < 0.01), MG capping, and pouting remained improved at D-90 (p < 0.01). MG foam, telangiectasia, bulbar hyperaemia and corneal staining improved significantly at D-42 (p < 0.01), but most changes diminished by D-90. The sham group showed no significant changes. No differences were observed in tear film parameters at any time point.

CONCLUSION

IPL therapy, effectively reduced symptoms of CLD and improved meibomian gland function, though effect diminished within 69 days after the final treatment, underscoring the need for optimized treatment protocols.

摘要

目的

评估强脉冲光(IPL)疗法对有症状的隐形眼镜佩戴者隐形眼镜不适(CLD)体征和症状的影响。

方法

对18名隐形眼镜佩戴者的36只眼睛(IPL组:n = 20;假治疗组:n = 16)进行了一项前瞻性、随机、双盲研究,这些佩戴者的隐形眼镜干眼问卷(CLDEQ - 8)评分≥12。参与者根据随机分组情况,每隔三周接受两次IPL/假治疗。假治疗组使用手电筒进行模拟光照,而IPL设备保持不活动状态。每次治疗后对两组均进行睑板腺挤压。症状和临床评估包括CLDEQ - 8问卷、非侵入性泪膜破裂时间(NITBUT)、泪膜脂质层厚度(TFLLT)、泪河高度(TMH)、泪液量、睑板腺分泌评分(MGSS)、睑板腺评分(上/下眼睑)、睑板腺堵塞、撅嘴、泡沫、毛细血管扩张、充血(球结膜、角膜缘和睑结膜)、睑结膜粗糙度、角膜染色以及睑结膜平行皱襞(LIPCOF)。在基线治疗前(D - 0)、然后在第21天(D - 21)、D - 42和D - 90进行评估。

结果

IPL组的CLDEQ - 8评分从D - 0时的18.1±1.9显著降低至D - 42时的10.7±1.1(p = 0.01),并且在D - 21(p = 0.02)和D - 42(p < 0.01)时睑板腺分泌评分(MGSS)得到改善,在D - 90时睑板腺堵塞和撅嘴情况仍持续改善(p < 0.01)。MG泡沫、毛细血管扩张、球结膜充血和角膜染色在D - 42时显著改善(p < 0.01),但到D - 90时大多数变化消失。假治疗组未显示出显著变化。在任何时间点,泪膜参数均未观察到差异。

结论

IPL疗法有效减轻了CLD症状并改善了睑板腺功能,尽管在最后一次治疗后69天内效果减弱,这突出了优化治疗方案的必要性。

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