物理治疗睑板腺功能障碍的疗效观察

目的:探讨睑板腺开口挑排等物理治疗睑板腺功能障碍(meibomian gland dysfunction,MGD)的疗效。方法:回顾性分析2012-01/12我院收治的MGD患者52例100眼的临床资料,根据临床表现及体征确诊为MGD,随机分为两组,A组(物理治疗组)26例50眼患者给予局部清洗、热敷、睑板腺开口挑排、妥布霉素地塞米松眼膏及人工泪液等综合治疗,B组(对照组)26例50眼患者仅用人工泪液和妥布霉素地塞米松眼膏药物治疗,比较两组治疗前后患者自觉症状、角膜荧光素染色(FL)、泪液分泌和泪膜破裂时间。结果:A组自觉症状好转24例47眼,好转率94%,B组自觉症状好转14例27眼,好转率54%,两组间差异有统计学意义(P<0.01);两组间泪液分泌治疗后无明显统计学差异(P>0.05);泪膜破裂时间(BUT)A组治疗后明显好转,治疗后2,4wk两组间比较有统计学意义(P<0.01);角膜荧光素染色(FL),治疗后2,4wk两组之间有统计学意义(P<0.05)。结论:MGD是一种可致眼表炎症及损伤的慢性疾病,睑板腺开口挑排等物理治疗睑板腺功能障碍疗效确切,患者满意度高。     

结膜松弛症睑板腺功能的临床观察

目的 探讨睑板腺功能障碍（MGD）与结膜松弛症（CCh）的关系,观察挤压睑板腺分泌排泄法对MGD的临床疗效.方法 前瞻性随机病例对照研究.选取CCh患者100例（200眼）,男45例,女55例,年龄为46～87岁,平均（72.6±5.5）岁.采用眼表面疾病指数（OSDI）积分法对患者进行眼部症状问卷调查评分;观察患者睑板腺开口;测定泪膜破裂时间（BUT）;对异常睑板腺分泌物行涂片染色;同时利用非接触红外线睑板腺照相系统进行睑板腺检查.对CCh伴有MGD患者随机分为睑板腺挤压治疗组（挤压组,24例）和抗生素眼液、人工泪液治疗组（对照组,22例）.治疗后1、2、4、8周进行随访观察,取第8周的数据进行统计学分析.对相关数据进行独立样本t检验或者配对t检验.结果 CCh伴有MGD者46例,占46％.不伴MGD患者的OSDI积分为21.6±5.9,伴MGD患者的OSDI积分为46.3±7.9,差异有统计学意义（t=17.172,P＜0.01）.MGD挤压治疗组治疗前的OSDI和睑板腺开口积分分别为45.8±8.9和2.1±0.3,治疗后分别为21.2±4.8和3.2±0.4,差异均有统计学意义（t=22.170、2.688,P＜0.05）.不伴MGD患者BUT值为（7.8±0.9）s,伴MGD患者的BUT值为（5.9±0.9）s,差异有统计学意义（t=6.189,P＜0.01）.挤压治疗组治疗前BUT值为（5.7±0.9）s,治疗后BUT值为（7.1±0.9）s,差异有统计学意义（t=10.110,P＜0.01）.对照组治疗前后除OSDI积分差异有统计学意义外（t=24.330,P＜0.01）,BUT及睑板腺开口积分差异无统计学意义.46例伴MGD患者的睑板腺分泌物涂片检查发现,26眼分泌物涂片除脂质外,还含有上皮细胞、正在凋亡的细胞和大量的细胞碎屑及少许炎症细胞,7例奶黄样分泌物涂片可见大量中性粒细胞和少量上皮细胞.结论 CCh多伴发MGD.睑板腺挤压治疗是一种有效的治疗MGD的方法,可以作为伴发MGD的CCh患者的重要的辅助治疗.     

老年睑板腺功能障碍蠕形螨感染率及茶树精油联合氟米龙的疗效

目的：研究老年睑板腺功能障碍(MGD)蠕形螨感染率及茶树精油联合氟米龙的疗效。

方法：回顾性病例对照研究。选择2017-09/2018-03在宁波市眼科医院门诊就诊的老年MGD患者59例118眼。将睫毛蠕形螨镜检为阳性的38例患者76眼进行症状评分、蠕形螨数量、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、Schirmer I试验(SIaT)等检查,并按不同治疗方法分成3组,A组使用0.02%氟米龙滴眼液滴眼24眼; B组使用茶树精油(TTO)湿巾敷眼26眼; C组用0.02%氟米龙滴眼液滴眼联合TTO湿巾敷眼26眼,随访4wk。

结果：118眼中76眼(64.4%)睫毛蠕形螨镜检为阳性。睫毛蠕形螨阳性的三组患者治疗后的主观症状评分均较治疗前有改善(P<0.05)。治疗后A组蠕形螨数量较治疗前无显著差异(P=0.11); B、C组较治疗前明显减少(均P<0.01)。三组患者BUT治疗前后比较,A组BUT无显著差异(P=0.22); B、C组BUT明显延长(均P<0.05)。治疗后C组的BUT较A、B组明显延长(均P<0.05)。三组患者治疗前后的FL评分均较治疗前明显改善(P<0.05)。

结论：老年MGD患者睫毛蠕形螨感染率较高,睑板腺热疏通后TTO湿巾联合0.02%氟米龙滴眼液能有效驱螨、缓解MGD患者局部症状。     

Efficacy of a new warm moist air device on tear functions of patients with simple meibomian gland dysfunction

PURPOSE: To evaluate the safety and efficacy of an original warm moist air device on tear functions and ocular surface of patients with simple meibomian gland dysfunction (MGD). METHODS: Fifteen patients with simple MGD and 20 healthy volunteers were recruited in an initial prospective interventional clinical trial to evaluate the safety and short-term effects of the warm moist air device. The device was applied to the eyes of the subjects for 10 minutes. Temperatures of the eye lids and corneas were measured with an infrared thermometer. Symptoms of ocular fatigue were scored using visual analog scales (VASs). Schirmer test, tear film break-up time (BUT), DR-1 tear film lipid layer interferometry, fluorescein staining, and rose bengal staining were also performed before and after the application of the eye steamer. After the initial study, another 2-week prospective clinical trial was carried out in 10 patients with MGD who received the warm moist air treatment. Ten other patients were also recruited and received warm compress treatment with hot towels for 2 weeks to evaluate the long-term effects of the warm moist air device and the warm compresses on tear film lipid layer thickness and ocular surface health. The warm moist air device and the warm compresses were applied for 10 minutes twice a day. The changes in VAS scores for symptoms, BUT values, fluorescein, and rose bengal staining scores were examined before and after each treatment during the second trial. RESULTS: VAS scores of ocular fatigue improved significantly with short- and long-term applications of the warm moist air device in both studies. The mean corneal surface and eye lid temperatures showed significant elevation within safe limits 10 minutes after the moist air application. The mean BUT prolonged significantly in the patients receiving warm moist air applications but did not change significantly in those treated with warm compresses. DR-1 tear film lipid layer interference showed evidence of lipid expression in the patients and controls, with thickening of the tear film lipid layer after 10 minutes of warm moist air device use. In the 2-week trial, tear film lipid layer thickness increased in both warm moist air device and warm compress groups, with a greater extent of increase in the warm moist air device group. CONCLUSION: Warm moist air device use provided symptomatic relief of ocular fatigue and improvement of tear stability in patients with MGD. The new warm moist air device seems to be a safe and promising alternative in the treatment of MGD.     

强脉冲激光治疗睑板腺功能障碍的临床观察

目的:研究强脉冲激光(intense pulsed light,IPL)对睑板腺功能障碍(eibomian gland dysfunction,MGD)的治疗效果,观察IPL是否改善MGD患者的症状.方法:回顾性非对照病例研究.选取2016-11/2017-02于武汉大学人民医院就诊的MGD患者21例42眼.检查方法:OSDI评分、角膜荧光素染色、泪膜破裂时间、眼表分析仪、共聚焦显微镜观察.所有患者每次IPL治疗间隔3wk,共行3次IPL治疗,1mo后门诊随访复查,采用配对样本t检验分析治疗前后结果差异.结果:治疗后,21例42眼患者OSDI评分降低,治疗前均值为30.18±4.07分,治疗后均值为24.87±4.32分;第一次泪膜破裂时间(first BUT)提高,治疗前均值为5.37±0.82s,治疗后均值为7.12±0.74s;平均泪膜破裂时间(mean BUT)提高,治疗前均值为7.73±1.14s,治疗后均值为11.37±2.23s;睑板腺分泌物评分降低,治疗前均值为1.57±0.52分,治疗后均值为1.22±0.52分;角膜荧光染色评分降低,治疗前均值为0.82±0.41分,治疗后均值为0.51±0.53分,差异均有统计学意义(t=11.2、2.68、3.31、2.78、2.61,P<0.05).结论:IPL可以有效改善MGD患者主观症状,改善睑板腺阻塞,是MGD治疗的重要手段.     

地夸磷索钠联合强脉冲光治疗角膜屈光手术后睑板腺功能障碍性干眼

目的:观察地夸磷索钠联合强脉冲光(IPL)对屈光术后睑板腺功能障碍(MGD)性干眼的治疗效果。方法:选取2021-03/12在本院进行激光角膜屈光手术后6mo内确诊的MGD性干眼患者64例128眼。随机分为对照组和试验组,对照组患者33例66眼接受玻璃酸钠联合IPL治疗,试验组患者31例62眼接受地夸磷索钠联合IPL治疗。两组患者每次IPL治疗前均进行眼部症状评分,检查非接触式泪膜破裂时间(NIBUT)、泪河高度、泪膜脂质层分级、睑板腺缺失率及裸眼视力。结果:IPL治疗后,两组患者眼部症状评分、睑板腺缺失率评分均持续降低,NIBUT、泪河高度、泪膜脂质层分级均持续升高,裸眼视力无明显变化,且第3次IPL治疗前试验组患者NIBUT优于对照组(6.24±0.27s vs 5.51±0.24s,P=0.046)。结论:地夸磷索钠和玻璃酸钠联合IPL均对MGD性干眼有较好的治疗效果,但短期内疗效差异不显著。     

Low-concentration homogenized castor oil eye drops for noninflamed obstructive meibomian gland dysfunction

OBJECTIVE: We developed low-concentration homogenized castor oil eye drops for the treatment of patients with noninflamed obstructive meibomian gland dysfunction (MGD), a major cause of lipid-deficiency dry eye, and assessed the safety, stability, and efficacy of the eye drops. DESIGN: Randomized, double-masked, placebo-controlled crossover clinical trial. PARTICIPANTS: Forty eyes of 20 patients with noninflamed MGD. METHODS: After a preliminary study of eye drops containing castor oil, 2% castor oil and 5% polyoxyethylene castor oil (emulsifier) were mixed to formulate homogenized oil eye drops. The patients were assigned randomly to receive oil eye drops or placebo six times daily for 2 periods of 2 weeks each. MAIN OUTCOME MEASURES: At the end of each treatment period, we assessed symptoms, tear interference grade, tear evaporation, fluorescein and rose bengal scores, tear break-up time (BUT), and meibomian gland orifice obstruction. Safety and stability tests were also performed. RESULTS: Symptom scores, tear interference grade, tear evaporation test results, rose bengal scores, tear BUT, and orifice obstruction scores after the oil eye drop period showed significant improvement compared with the results after the placebo period. No complications attributable to the eye drops were observed. The oil eye drops were stable when stored at 4 degrees C. CONCLUSIONS: The results indicate that castor oil eye drops are effective and safe in the treatment of MGD. The possible mechanisms of this treatment are improvement of tear stability as a result of lipid spreading, ease of meibum expression, prevention of tear evaporation, and the lubricating effect of the oil eye drops.     

不同频率强脉冲光联合睑板腺按摩治疗睑板腺功能障碍导致的干眼症患者的临床疗效

目的　探讨不同治疗频率强脉冲光（IPL）联合睑板腺按摩治疗睑板腺功能障碍（MGD）导致的干眼症患者的临床疗效。方法　选取2017年8月至2018年8月于西安市人民医院（西安市第四医院）眼屈光中心就诊的患有MGD导致的干眼症患者30例60眼,最终纳入25例50眼。分别在0周,间隔1周（第1周）、间隔2周（第3周）以及间隔4周（第7周）各进行1次IPL治疗,共治疗4次。对患者进行问卷调查眼表疾病指数量表评分;采用眼表综合分析仪定量测定各间隔治疗期患者泪河高度、平均非侵入性泪膜破裂时间、首次非侵入性泪膜破裂时间,通过红外照相功能检测患者睑板腺缺失情况;对患者睑板腺分泌能力、睑板腺分泌物性状进行评分,并行角膜荧光素染色检查。结果　治疗间隔1周、间隔2周和间隔4周时患者的眼表疾病指数量表评分明显低于治疗前,而治疗间隔1周、间隔2周和间隔4周之间的差异无统计学意义（P>0.05）; 非侵入性泪膜破裂时间、首次非侵入性泪膜破裂时间在各治疗间隔期明显高于治疗前（均为P<0.05）;两两比较显示治疗间隔1周、间隔2周的泪河高度高于治疗前（均为P<0.05）,治疗间隔4周的泪河高度较间隔1周和间隔2周下降（均为P<0.05)。治疗间隔1周、间隔2周、间隔4周的睑板腺分泌能力评分均低于治疗前（均为P<0.05）;治疗间隔2周和间隔4周的睑板腺分泌能力评分均低于治疗间隔1周（均为P<0.05）。治疗间隔1周、间隔2周、间隔4周的睑板腺分泌物性状评分均低于治疗前（均为P<0.05）;治疗间隔4周的睑板腺分泌物性状评分低于治疗间隔1周（P<0.05）。治疗间隔1周、间隔2周、间隔4周的角膜荧光素染色等级均低于治疗前（均为P<0.05）。经IPL联合睑板腺按摩治疗4次后患者睑板腺的腺体较治疗前清晰,睑结膜面的新生血管及炎症的红外成像明显减轻,但未见缺失睑板腺腺体恢复。结论　IPL联合睑板腺按摩治疗可缓解MGD导致的干眼症患者的干眼症状,治疗间隔2周可以很好地兼顾疗效和安全性以及患者的经济负担。     

Treatment of non-inflamed obstructive meibomian gland dysfunction by an infrared warm compression device

AIM: To test the short term efficacy and safety of an infrared warm compression device (IWCD, Eye Hot, Cept Co, Tokyo, Japan) as treatment for non-inflamed meibomian gland dysfunction (MGD). METHODS: 37 subjects with non-inflamed obstructive MGD, with and without aqueous tear deficiency (ATD) dry eye, participated in a prospective non-comparative interventional case series. Symptom scores, face scores, tear evaporation rates, fluorescein and rose bengal vital staining, tear break up time (BUT), Schirmer test, meibomian gland obstruction, and meibography were compared before and after 2 weeks of therapy. RESULTS: In a total of 37 cases, total subjective symptom scores and subjective face scores improved significantly, from 12.3 (SD 5.9) to 8.4 (6.1), and from 7.0 (1.7) to 5.3 (2.0) (both p <0.0001). The results for tear evaporation rates during forced blinking (p = 0.002), fluorescein staining (p = 0.03), rose bengal staining (p = 0.03), BUT (p <0.0001), and meibomian gland orifice obstruction score (p <0.0001) had also improved significantly at the end of the 2 week period of infrared thermotherapy. No complaints and/or complications of the IWCD were reported. CONCLUSION: The IWCD was effective and safe for the treatment of MGD. Improved tear stability associated with release of meibum is a possible mechanism of this treatment.     

局部应用地塞米松治疗睑板腺功能障碍相关性干眼的疗效观察

目的  比较单纯应用抗生素以及联合糖皮质激素治疗睑板腺功能障碍（MGD）相关性干眼的临床效果。设计  前瞻性比较性病例系列。研究对象  2012年5月浙江大学医学院附属第二医院眼科中心诊断为MGD相关性干眼患者42例（84眼）。方法  随机选择其中22例（44眼）为试验组,应用妥布霉素地塞米松眼膏+羟糖甘滴眼液+局部热敷;20例（40眼）为对照组应用妥布霉素眼膏+羟糖甘滴眼液+局部热敷。于治疗前和治疗后1、2和4周观察睑板腺功能及其干眼相关检测指标的变化及症状改善情况。主要指标 睑板腺功能方面：裂隙灯显微镜下评价眼睑睑缘变化,睑板腺开口的变化,睑板腺分泌物性状评分,睑板腺脂质排出难易度评分;干眼方面： Schirmer I试验（SIt）、泪膜破裂时间（TBUT）、角膜荧光素染色（CFS）情况及症状评分。结果  治疗前,试验组和对照组在年龄、MGD病程、MGD体征和干眼体征等各项指标均无统计学差异（P均>0.05）。与治疗前相比,治疗后1、2、4周,实验组和对照组的分泌物性状评分、睑板腺脂质排出难易度评分和症状评分均明显降低,TBUT均明显增加（P均<0.05）。两组的CFS评分在治疗后2、4周比治疗前均明显降低（P均<0.05）。治疗后1、2周时,与对照组相比,试验组的睑板腺分泌物性状评分和睑板腺挤压试验评分明显较低,而在治疗后各时间点TBUT值明显较高（P均<0.05）。结论  单纯抗生素以及联合糖皮质激素治疗对MGD相关性干眼均有疗效,但后者在改善症状及体征方面效果更优。     

显微探针疏通术在睑板腺功能障碍治疗中的应用

目的：研究显微探针疏通技术在睑板腺功能障碍（meibomian gland dysfunction,MGD）治疗中的作用,以期为MGD的治疗提供快速有效、经济实用的治疗方法。 方法：选取直径为100μm的不锈钢丝作为材料,制作成总长度约3cm 的探针,其中操作针头长约5mm,手柄长约2.5 cm。选取睑板腺功能障碍性干眼症患者140例,分为两组并使其有可比性。观察组（ n=70）利用显微探针对阻塞的睑板腺管进行疏通,配以药物、热敷、睑板腺按摩等治疗。对照组（ n=70）给予常规给予药物、热敷、睑板按摩治疗。对两组患者治疗后1 d;1,2 wk;1,2,3 mo的BUT、有效率及治愈率进行比较。 结果：观察组与对照组经过治疗后BUT均明显延长,且观察组改善更为明显;治疗后1 d;1,2 wk;1,2,3 mo观察组治愈率、有效率均明显高于对照组。 结论：利用显微探针对睑板腺管进行疏通,能为MGD的治疗提供快速有效、经济实用的治疗方法,可以在临床中进行推广。     

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Purpose:To compare the efficacy of physiological, non-detergent eyelid wipes with conventional lid hygiene in patients with meibomian gland dysfunction (MGD).Methods:Fifty participants with MGD were recruited and randomized into two groups. Participants in group I used Evolve Pure™ Eyewipes twice a day to clean the eyelid debris along with standard therapy (antibiotic and lubricants) and participants in group II followed lid hygiene with warm compresses along with standard therapy. Symptoms, ocular surface assessment (lipid layer thickness, tear meniscus height, non-invasive tear film breakup time, and meibography), slit-lamp biomicroscopy (eyelash contamination, meibomian gland blockage, meibomian gland secretion, and meibomian gland telangiectasia) and tear film osmolarity were noted at baseline and 90 days after therapy.Results:Significant improvement in symptoms and signs of MGD was observed in both groups after treatment (P < 0.001); however, the clinical improvement was better with the use of eyelid wipes. Lipid layer thickness increased significantly in group I (P = 0.0006) and group II (P = 0.0002), which was maintained even after adjusting for sociodemographic variables such as age, sex, and severity score of symptoms and signs.Conclusion:Lipid layer thickness of the tear film is a sensitive marker in monitoring response to treatment in patients with MGD. The use of physiological detergent-free eyelid wipes is non-inferior to lid hygiene and warm compresses, which remains the mainstay for treatment of MGD; the clinical improvement with eyelid wipes was noted to be better.     

热敷按摩改善睑板腺功能障碍患者的白内障术后疗效

目的：评价白内障术前进行眼睑热敷联合睑板腺按摩对白内障合并轻中度睑板腺功能障碍（MGD） 患者白内障术后临床效果的改善。方法：前瞻性临床研究。收集2019年9月至2020年6月于温州医科大学附属眼视光医院杭州院区就诊的50～85岁轻中度MGD合并白内障的患者,按随机数字表法分为实验组和对照组,实验组先接受3次眼睑热敷联合睑板腺按摩治疗再行白内障手术,对照组直接行白内障手术。分别记录MGD治疗前、治疗后以及白内障术后1周、1个月、3个月时的泪液分泌试验（SⅠT）、泪膜破裂时间（TBUT）、角结膜染色评分、睑板腺功能评分;眼表综合分析仪（keratograph 5M）检查并记录非侵入性泪河高度（NITMH）、非侵入性泪膜破裂时间（NITBUT）和睑板腺缺失范围（MGL）;采用眼表疾病指数（OSDI）问卷得分进行评估。使用广义估算方程（GEE）、广义线性混合模型（GLMM）、独立样本t检验及Mann-Whitney U检验进行数据分析。结果：共纳入77例（77眼）, 最终纳入分析68例（68眼）,每组34例。实验组在MGD治疗后,睑缘形态、睑板腺排出能力、SⅠT、 TBUT及OSDI评分较MGD治疗前明显好转（P<0.05）;角膜点染在白内障术后1周时较治疗前增加 （P=0.002）,至术后1个月时恢复至治疗前水平。组间比较发现,实验组睑脂质量变化量在白内障术后各时间点均明显优于对照组（P<0.05）;白内障术后1周时,实验组睑缘形态的变化量小于对照组, 术后1个月时,NITMH变化量小于对照组,而OSDI评分变化量大于对照组（P<0.05）,实验组症状及体征更轻;对照组在白内障术后1周时,睑缘形态及SⅠT明显变差,至术后1个月时恢复至术前水平; 睑脂质量在术后1周时变差,NITMH在术后1个月时减少,二者至术后3个月时恢复至术前水平。结论： 白内障术前采用眼睑热敷联合睑板腺按摩治疗MGD,可改善术后睑板腺功能状态,缓解干眼症状。     

Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction

Purpose

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).

Tear film with "Orgahexa EyeMasks" in patients with meibomian gland dysfunction

PURPOSE: To evaluate the efficacy of a new Orgahexa eye warmer mask for patients with simple meibomian gland dysfunction (MGD) in a prospective comparative study. METHODS: Twenty right eyes of 20 patients with simple MGD, and 22 right eyes of 22 healthy controls were studied. Subjects were allocated to Orgahexa or conventional eye mask wear for 10 min (short-term study), and for 2 weeks (long-term study). Eyelid temperature measurements, slit lamp examination, tear film break-up time, Schirmer test, vital staining, tear film lipid layer interferometry, and dry eye symptomatology scoring with visual analog scales were performed. RESULTS: The Orgahexa eye warmer improved both tear function and ocular surface status, and decreased symptoms significantly without any complications. CONCLUSIONS: The Orgahexa eye warmer is a simple, safe, and convenient method, which seems to improve the ocular surface status and tear functions in patients with simple MGD.     

强脉冲光联合睑板腺按摩治疗睑板腺功能障碍的短期疗效

目的：评估强脉冲光（IPL）联合睑板腺按摩（MGX）（IPL/MGX）治疗睑板腺功能障碍（MGD）的短期 疗效。方法：前瞻性临床研究。选择2016年11月至2017年12月于汉口爱尔眼科医院门诊连续就诊 的MGD患者55例,最终完成随访的有48例（96眼）,双眼均行IPL/MGX治疗,每3周治疗1次,共3次。 在治疗前、治疗结束后1周进行眼表疾病指数（OSDI）问卷调查、泪膜破裂时间、角膜染色、睑板腺 功能及成像、结膜眼红评分、共聚焦显微镜下睑板腺及蠕形螨检查等。使用配对t检验、Wilcoxon 秩和检验及Spearman秩相关分析对数据进行处理。结果：IPL/MGX治疗结束后1周与治疗前比较, OSDI评分降低（t=2.300,P=0.024）,睑板腺分泌能力与睑酯质量均得到改善（Z=-3.617,P<0.001;t= 2.472,P=0.017）,角膜染色评分、球结膜眼红评分降低（Z=-2.757,P=0.006;t=2.040,P=0.044）,睑 板腺腺周炎症细胞密度下降（t=4.765,P<0.001）,睫毛根部蠕形螨总数减少（t=2.121,P=0.037）。睑 板腺萎缩面积<50%的MGD患者,治疗后症状评分、眼表炎症状态及睑板腺功能显著改善,睑板腺 萎缩面积≥70%的MGD患者,治疗前后各项指标均未见明显改善。结论：IPL/MGX可明显改善睑板 腺萎缩程度尚轻的MGD患者主观症状及睑板腺功能,减轻患者眼表炎症,减少眼蠕形螨数量,降低 眼表损害。     

睑板腺功能障碍的临床疗效分析

目的:分析妥布霉素地塞米松眼膏治疗睑板腺功能障碍(meibomain gland dysfunction,MGD)的短期临床效果。方法:选择2012-01/06诊治的MGD患者87例174眼,所有患者按照就诊顺序分为红霉素眼膏组、妥布霉素地塞米松眼膏组和对照组,分析治疗前、治疗后1wk和4wk的观察指标。结果:三组患者的症状评估(SS)、泪膜破裂时间(BUT)、角膜荧光素染色评分(CFS)、基础泪液分泌量(SⅠt)、睑缘观察评分(LMS),治疗前与治疗后1wk和4wk比较,存在统计学差异(P<0.05),说明三种治疗皆有效;治疗后1wk和4wk,红霉素眼膏和妥布霉素地塞米松眼膏组与对照组比较,在SS和LMS方面存在统计学差异(P<0.05);治疗后1wk和4wk妥布霉素地塞米松眼膏组和红霉素眼膏在SS,BUT和LMS方面存在统计学差异(P<0.05),说明妥布霉素地塞米松眼膏组以上指标效果优于红霉素眼膏组。结论:妥布霉素地塞米松眼膏对MGD临床效果良好,不但能够改善MGD患者的症状体征,而且抗炎效果满意。     

参麦润目组方超声雾化治疗睑板腺功能障碍相关性干眼的疗效

目的：探讨参麦润目组方超声雾化治疗睑板腺功能障碍(MGD)相关性干眼的临床效果。

方法：收集120例MGD相关性干眼患者,随机分为2组：治疗组(参麦润目组方超声雾化)与对照组(OPT强脉冲光疗)各60例,两组均联合睑板腺按摩。采用眼表综合分析仪检测各项指标：非侵入性平均泪膜破裂时间(NITBUTav)、下泪河高度(LTMH)、睑板腺评分等,对患者眼部的主观症状以问卷调查进行评分,将所得临床数据进行统计学处理。

结果：治疗组与对照组的治疗前性别、年龄、病程及治疗开始至结束后6mo的各项检测指标无差异(P>0.05); 治疗组总有效率94.9%,对照组96.6%(P>0.05)。

结论：参麦润目组方超声雾化联合睑板腺按摩可改善MGD相关性干眼患者的主观症状及客观指标。该治疗方法与现代医学治疗方法疗效基本等同,安全并且有效,但更为便捷、经济。     

中老年睑板腺功能障碍的临床分析

目的:探讨中老年患者睑板腺功能障碍(MGD)的临床特点及诊治要点。方法:通过问卷调查、泪膜破裂时间、ShimmerⅠ试验、角膜荧光素染色及睑板腺分泌物的检查,将74例145眼睑板腺功能障碍患者分为轻度、中度、重度三组,根据疾病程度,分别行睑缘清洁、疏通、按摩、人工泪液、或抗炎、抗感染等联合治疗。结果:睑板腺功能障碍患者74例145眼治疗1mo后,眼表疾病指数评分下降,睑腺分泌物评分下降,泪膜破裂时间延长,眼表活体染色评分下降。各型MGD的总治愈率34.5%,总有效率98.6%。结论:眼科医师应掌握中老年睑板腺功能障碍的临床特点,重视症状、病史的询问及眼表及睑板腺功能的检查。避免睑板腺功能障碍的误诊、误治。     

睑板腺功能障碍患者IntraLase-LASIK术前睑板腺处理的临床观察

目的：：观察睑板腺功能障碍患者术前行睑板腺处理对飞秒激光制瓣膜的准分子激光角膜原位磨镶术( IntraLase-LASIK)术后眼表炎症反应和泪膜状态的改变。方法：选取2014-03/09来我院屈光门诊就诊拟行IntraLase-LASIK术并有不同程度睑板腺功能障碍的患者35例70眼。随机数字法将患者分为两组：观察组17例34眼术前给予睑板腺的特殊处理,对照组18例36眼术前不进行睑板腺处理,两组其余操作相同。观察IntraLase-LASIK术后1 d和1 wk眼球结膜充血、畏光、干涩感评分及泪膜破裂时间( tear break-up time,BUT)的变化。结果：术后1 d和1 wk观察组的球结膜充血、畏光、干涩感评分及BUT均低于对照组( P<0.05)。结论：睑板腺功能障碍的患者术前睑板腺处理可以减轻术后的眼表刺激症状,对泪膜起到一定的稳定作用,提高患者术后的满意度。