眼表综合分析仪用于围绝经干眼女性眼表相关指标分析的临床评价

目的 应用眼表综合分析仪分析评价围绝经干眼女性眼表相关指标.方法 选择67例(134眼)围绝经期干眼女性作为研究对象.运用眼表疾病指数(OSDI)量表进行干眼症状评估,使用眼表综合分析仪Keratograph 5M进行泪河高度、泪膜破裂时间(TBUT)、脂质层和睑板腺检查.结果 134眼的OSDI评分为(2.27±1.64)分,泪河高度为(0.17±0.19) mm,TBUT为(4.69±2.17)s,脂质层评分为(1.375±1.06)分,睑板腺面积评分为(0.79±0.78)分.泪河高度、脂质层评分、TBUT与OSDI评分呈负相关(r=-0.612、r=-0.635、r=-0.593,P＜0.05),睑板腺面积评分与OSDI评分呈正相关(r=0.672,P＜0.05).结论 脂质层稳定性和睑板腺功能异常也是围绝经期女性干眼形成的重要因素.     

睑板腺按摩对睑板腺功能障碍性干眼的护理效果观察

目的 探讨睑板腺按摩对睑板腺功能障碍性干眼的护理效果。方法 睑板腺功能障碍性干眼患者69例138眼分为对照组和观察组,对照组:进行常规的抗生素滴眼液及人工泪液补充治疗;观察组:进行常规的抗生素滴眼液及人工泪液补充治疗,辅以睑板腺按摩每周护理2次。在治疗前、治疗结束以及治疗结束后4周时记录患者泪膜破裂时间、角膜荧光素染色评分和睑缘评分,并使用SPSS 21.0对测量结果进行统计学分析。结果 治疗结束时,观察组患者的泪膜破裂时间长于对照组 (F=11.364,P=0.020),角膜荧光素染色评分低于对照组(F=2591.741,P＜0.001),睑缘评分高于对照组(F=20.941,P＜0.006);治疗结束后4周时,观察组患者的泪膜破裂时间、角膜荧光素染色评分和睑缘评分结果均优于对照组,差异有统计学意义(P＜0.05)。结论 对于睑板腺功能障碍性干眼患者,睑板腺按摩是一种有效的护理及治疗方法,可显著改善眼表、泪膜及睑板腺状况。     

聚乙二醇滴眼液联合改良睑板腺疏通治疗青年睑板腺功能异常患者干眼的临床观察

目的:了解聚乙二醇滴眼液联合改良睑板腺疏通治疗青年睑板腺功能异常患者干眼的疗效。方法:选取青年睑板腺功能异常伴干眼患者46例92眼,随机分为两组,其中治疗组23例给予聚乙二醇滴眼液联合改良睑板腺疏通治疗,进行改良睑板腺疏通方法的指导,回家自行睑板腺疏通,每天3次。对照组23例单纯给予聚乙二醇滴眼液。两组聚乙二醇滴眼液均每天4次,连续治疗4周后复查。记录两组治疗前、后SchirmerⅠ试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色(CFL)情况。结果:两组治疗前后BUT、CFL差异均有统计学意义(P<0.05)。两组治疗前后SⅠt稍有改善,但差异无统计学意义(P>0.05)。治疗后两组BUT,CFL比较,差异有统计学意义(P<0.05)。结论:聚乙二醇滴眼液联合改良睑板腺疏通对青年睑板腺功能异常患者干眼具有明显疗效,且改良睑板腺疏通操作简便,掌握方法后可以自行疏通。     

中西医结合治疗结膜松弛症伴MGD相关干眼相关干眼的疗效分析

目的:观察中西医结合治疗结膜松弛症伴MGD相关干眼相关干眼的临床疗效。方法:将结膜松弛症伴MGD相关干眼的患者116例(232只眼)分为治疗组及对照组。治疗组采用复明片口服联合西医治疗,对照组采用单纯西医治疗。观察治疗及治疗后3个月患者泪膜破裂时间(BUT)、角膜荧光素染色(CFS)、泪液分泌试验(SIT)、睑脂性状、睑板腺挤压试验和以及眼部症状评价。结果:中西医结合治疗组的治疗效果在泪膜破裂时间(BUT)、角膜荧光素染色(CFS)评分、泪液分泌试验(SIT)、睑脂性状评分、眼部症状评价评分及治疗有效率优于西医组(P0.05),在睑板腺脂质排出难易度评分无统计学差异。结论:中西医结合治疗在治疗结膜松弛伴MGD的患者中具有一定的优势,中药治疗可作为一种有效的辅助治疗手段。     

眼表综合治疗联合睑板腺按摩对睑板腺功能障碍型干眼的临床治疗效果研究

目的:探讨眼表综合治疗联合睑板腺按摩对睑板腺功能障碍型干眼的临床治疗效果研究。方法:随机抽取我院2017年12月-2018年8月接受治疗的210例睑板腺功能障碍型干眼患者,将其随机分为两组,对照组和实验组,对照组采用人工泪液点眼加左氧氟沙星滴眼液滴眼,实验组采用左氧氟沙星滴眼液加入灭菌注射用水中熏蒸眼部、中药热奄包热敷、睑板腺镊按摩、冷敷综合治疗。评价治疗两周后两组患者主观症状改善情况,睑板腺阻塞改善、泪液分泌试验、泪膜破裂时间及角膜荧光染色改善情况。结果:实验组患者主观症状改善情况,睑板腺阻塞改善情况、泪液分泌试验、泪膜破裂时间及角膜荧光染色改善情况明显优于对照组,两组结果有统计学差异。结论:使用药物熏蒸、中药热奄包热敷可以扩张睑板腺,再利用睑板腺按摩促进睑板腺脂质分泌和排除,加之冷敷后收缩修复扩张的睑板腺,从而达到改善内膜脂质层缺乏状态,疏通睑板腺,改善和减轻患者干眼症状。     

重组牛碱性成纤维细胞生长因子眼用凝胶和玻璃酸钠滴眼液对睑板腺异常相关干眼的效果对比分析

目的对比分析重组牛碱性成纤维细胞生长因子眼用凝胶和玻璃酸钠滴眼液对睑板腺异常相关干眼的治疗效果。方法 75例(75只眼)睑板腺异常相关干眼患者,随机分为观察组(37例)和对照组38例。观察组采用重组牛碱性成纤维细胞生长因子眼用凝胶进行治疗,对照组采用玻璃酸钠滴眼液进行治疗。比较两组患者的治疗前后临床相关症状评分及疗效。结果两组患者治疗后40 d的临床症状评分、泪膜破裂的时间及角膜荧光染色的评分与治疗前和治疗后20 d比较差异有统计学意义(P<0.05),但泪液分泌时间和睑板腺评分与治疗前和治疗后20 d比较差异无统计学意义(P>0.05);治疗后40 d观察组临床症状评分、泪膜破裂时间以及角膜染色的评分优于对照组(P<0.05)。结论采用重组牛碱性成纤维细胞生长因子眼用凝胶和玻璃酸钠滴眼液进行治疗都可以改善患者的临床症状,延长泪膜破裂的时间,修复角膜的损伤,但采用重组牛碱性成纤维细胞生长因子眼用凝胶的治疗效果明显优于采用玻璃酸钠滴眼液的治疗效果。但两者对睑板腺功能障碍的治疗效果都不太明显,需要配合其他药物进行治疗。     

睑板腺按摩对睑板腺功能障碍性干眼的护理效果分析

目的探讨睑板腺按摩对睑板腺功能障碍性干眼的护理效果。方法将2017年2月至2018年3月90例睑板腺功能障碍性干眼患者随机数字表法分组,对照组施行常规化护理干预,睑板腺按摩组应用睑板腺按摩护理。比较两组睑板腺功能障碍性干眼患者对护理服务满意度;眼干、烧灼感、异物感、疲劳感、畏光消失时间;护理前后患者症状积分、BUT时间;护理投诉发生率。结果睑板腺按摩组睑板腺功能障碍性干眼患者对护理服务满意度高于对照组,P <0.05;睑板腺按摩组眼干、烧灼感、异物感、疲劳感、畏光消失时间优于对照组,P <0.05;护理前两组症状积分、BUT时间相近,P> 0.05;护理后睑板腺按摩组症状积分、BUT时间优于对照组,P <0.05。睑板腺按摩组护理投诉发生率低于对照组,P <0.05。结论睑板腺按摩护理在睑板腺功能障碍性干眼护理中的应用效果确切,可加速各项症状消失,缩短疗程,减少投诉,患者对护理服务满意度高。     

0.3%爱丽联合典必殊眼膏治疗腺功能障碍性干眼症的疗效分析

目的探讨.0.3%爱丽联合典必殊眼膏治疗腺功能障碍性干眼症疗效。方法根据随机数字表法进行2017年11月至2018年4月门诊90例腺功能障碍性干眼症患者分成2组。对照组给予0.3%爱丽点眼及睑板腺按摩治疗,观察组则给予爱丽联合典必殊眼膏及睑板腺按摩治疗。比较两组腺功能障碍性干眼症治疗之后获得的效果;干眼表现消失时间;治疗前后患者泪液总分泌量以及泪膜破裂的时间;用药过程产生的不良反应发生率。结果观察组腺功能障碍性干眼症治疗之后获得的效果高于对照组,P <0.05;观察组干眼表现消失时间显著短于对照组,P <0.05;治疗前两组泪液总分泌量以及泪膜破裂的时间并无明显差异,P> 0.05;治疗后观察组泪液总分泌量以及泪膜破裂的时间优于对照组,P <0.05。两组用药安全性比较,P> 0.05。结论爱丽联合典必殊治疗腺功能障碍性干眼症的疗效确切,可有效改善泪液总分泌量以及泪膜破裂的时间,药物安全性好,值得推广应用。     

睑板腺按摩联合羟糖甘滴眼液治疗干眼的临床研究

目的：探析干眼患者进行睑板腺按摩与羟糖甘滴眼液治疗的临床研究。方法96例干眼患者,随机分为观察组与对照组,每组48例。观察组进行睑板腺按摩与羟糖甘滴眼液治疗,对照组仅进行羟糖甘滴眼液治疗,两组均治疗3个月,治疗后比较两组的临床有效率;比较角膜荧光素染色(CFS)评分、泪液分泌试验(SIt)、泪膜破裂时间(BUT)等临床指标。结果观察组、对照组的临床有效率分别为91.7%、70.8%,差异有统计学意义(P<0.05);观察组治疗后CFS评分、SIt、BUT等临床指标显著优于对照组(P<0.05)。结论干眼患者进行睑板腺按摩联合羟糖甘滴眼液治疗,能有效缓解干眼症状,临床效果确切,值得临床推广。     

睑板腺按摩与睑板腺疏通治疗青年睑板腺功能异常干眼症患者的临床分析

目的探讨睑板腺按摩与睑板腺疏通治疗青年睑板腺功能异常干眼症患者的临床效果。方法选取我院(2016年1月至2018年1月)收治的青年睑板腺功能异常干眼症患者96例,根据不同治疗方法分为两组,对照组(n=48)接受聚乙烯醇滴眼液滴眼治疗,观察组(n=48)在聚乙烯醇滴眼液滴眼治疗的基础上接受睑板腺按摩与睑板腺疏通治疗,对比两组患者治疗前后患者睑板腺功能(基础泪液分泌试验、泪膜破裂时间)和睑板腺评分以及临床疗效。结果治疗前两组患者基础泪液分泌试验、泪膜破裂时间、睑板腺评分对比差异不明显,无统计学意义(P>0.05);治疗后观察组基础泪液分泌试验、泪膜破裂时间明显高于对照组,睑板腺评分明显低于对照组,差异具有统计学意义(P<0.05)。两组患者临床疗效对比95.83%vs85.42%差异明显,具有统计学意义(P<0.05)。结论在常规治疗的基础上,联合使用睑板腺按摩与睑板腺疏通可有效缓解患者干眼症状,并提高临床疗效,分析是两种方法联合使用可促进睑板腺口有效疏通,提高泪膜稳定性,值得临床推广。     

地夸磷索滴眼液在干眼治疗中的应用

干眼指由任何原因造成的泪液质或量异常或动力学异常,导致泪膜稳定性下降,从而出现眼部不适、眼表组织病变的一类疾病,目前其治疗包括病因治疗、药物治疗、手术治疗等。地夸磷索是一种嘌呤P2Y2受体激动剂,可促进泪液和黏蛋白的分泌。3%地夸磷索滴眼液在水液缺乏型、蒸发过强型、黏蛋白缺乏型、混合型干眼中应用,表现出良好的临床疗效。3%地夸磷索滴眼液常见不良反应有眼部刺激、眼分泌物增多等,多程度轻微,患者耐受性良好。     

Pharmacotherapy of dry eye

Introduction: Based on data from the largest studies of dry eye to date – the Women's Health Study (WHS) and the Physicians' Health Study (PHS) – and other studies, it has been estimated that about 3.23 million women and 1.68 million men, for a total of 4.91 million Americans aged ≥ 50 years, have dry eye. Tens of millions more have less severe symptoms and probably a more episodic manifestation of the disease that is notable only during contact with some adverse contributing factor(s), such as low humidity or contact lens wear. Dry eye disease is a common yet frequently under-recognized public health problem whose etiology and management challenge clinicians and researchers involved in this field.

Areas covered: Advances in the understanding of the disease have been made over the past 10 years in areas of epidemiology, pathogenesis, clinical manifestation, and possible therapy. Historical aspects and recent information in relation to the use of artificial tear substitutes and anti-inflammatory agents in dry eye disease, including topical cyclosporin and corticosteroids, autologous serum, tetracyclines and systemic immunosuppressants, are covered in this review. The reader will gain insight into the recent views on the pharmacological menu of treatments for dry eyes following the recommendations of the 2007 International Dry Eye Workshop.

Expert opinion: Dry eye is a visually disabling disease, the treatment of which needs tailoring according to the type and severity of dry eye disease.     

Pharmacotherapy of dry eye

INTRODUCTION: based on data from the largest studies of dry eye to date - the Women's Health Study (WHS) and the Physicians' Health Study (PHS) - and other studies, it has been estimated that about 3.23 million women and 1.68 million men, for a total of 4.91 million Americans aged ≥ 50 years, have dry eye. Tens of millions more have less severe symptoms and probably a more episodic manifestation of the disease that is notable only during contact with some adverse contributing factor(s), such as low humidity or contact lens wear. Dry eye disease is a common yet frequently under-recognized public health problem whose etiology and management challenge clinicians and researchers involved in this field. AREAS COVERED: advances in the understanding of the disease have been made over the past 10 years in areas of epidemiology, pathogenesis, clinical manifestation, and possible therapy. Historical aspects and recent information in relation to the use of artificial tear substitutes and anti-inflammatory agents in dry eye disease, including topical cyclosporin and corticosteroids, autologous serum, tetracyclines and systemic immunosuppressants, are covered in this review. The reader will gain insight into the recent views on the pharmacological menu of treatments for dry eyes following the recommendations of the 2007 International Dry Eye Workshop. EXPERT OPINION: dry eye is a visually disabling disease, the treatment of which needs tailoring according to the type and severity of dry eye disease.     

Therapeutic targets in dry eye syndrome

Dry eye is a multifactorial disease of the tears and the ocular surface that manifests with a wide variety of signs and symptoms. It is prevalent in about 33% of the population worldwide. Due to the importance of the pathology, new tests, drugs and technologies have been developed to assist the diagnosis, management and follow-up of the disease. Current available therapies try to alleviate symptoms and to reduce signs in order to restore the ocular surface. Depending on the etiology of the pathology it is possible to use lubricants, secretagogues, biological tear substitutes or antiinflammatory drugs, either independently or combined. Nowadays, the therapies under clinical trial are devoted to stimulating tear components (e.g., diquafosol, a P2Y receptor agonist), or mucin secretion (e.g., rebamipide, an amino acid analogue of quinolinone). Others include gefarnate, a water-insoluble terpene fatty acid that contributes to restoring mucins on the ocular surface, or cevimeline, an oral cholinergic agonist that reduces the symptoms associated with dry eye. Other potential compounds described in patents are in a lower phase of drug development. These compounds come from different families of therapies, and among others, can be found in the form of steroidal and nonsteroidal antiinflammatory agents, vitamins A and D, neurotransmitters and neuropeptides.     

眼科门诊干眼症的流行病学调查及危险因素分析

目的探讨眼科门诊干眼症患病状况及相关危险因素。方法选取2008年2月～2012年2月本院1696例眼科门诊患者进行问卷调查,行特异性检查、裂隙灯检查、角膜荧光素染色。对干眼症确诊者依1∶2配比手段展开病例对比,分析相关危险因素。结果 1696例患者中,188例（占11.08%）为干眼症,女136例（占72.34%）,男52例（占27.66%）;〈20岁6例（占3.19%）,20～40岁79例（占42.02%）,〉40岁103例（占54.79%）,113例（占60.11%）长期使用抗生素、激素滴眼液。结论干眼症患者在性别、年龄等方面差异较大,而长期使用抗生素、激素滴眼液可能是干眼症的危险因素。     

Hydroxypropyl-guar gellable lubricant eye drops for dry eye treatment

The combined use of low dose heparin and glycoprotein (GP) IIb/IIIa blockers is standard treatment during percutaneous coronary interventions (PCIs). Bivalirudin has a different mechanism of anticoagulant action than heparin. In REPLACE-2, patients undergoing PCI were randomised to bivalirudin with provisional GP IIb/IIIa blockade or heparin and planned GP IIb/IIIa blockade. The primary quadruple composite end point was death, myocardial infarction, urgent repeat revascularisation or in-hospital major bleeding by 30 days, and statistical analysis showed that bivalirudin was not inferior to heparin plus GP IIb/IIIa blockade. There were fewer major and minor bleeding events with bivalirudin than with heparin plus GP IIb/IIIa blockade. Bivalirudin and provisional GP IIb/IIIa blockade should now be considered as an alternative to heparin plus planned GP IIb/IIIa blockade in patients undergoing urgent or elective revascularisation.     

Ciclosporin use in dry eye disease patients

Background: Dry eye disease is one of the most commonly encountered conditions in eye care, and inflammation is a frequent finding. Ciclosporin has long been used systemically to decrease the deleterious effects of inflammation. Ciclosporin is a calcineurin inhibitor that acts by primarily blocking the action of T cells, decreasing the release of pro-inflammatory cytokines, and preventing the apoptosis of goblet cells. Objective: This article reviews the clinical trials and safety profile of an ophthalmic preparation of ciclosporin in the treatment of dry eye. Results/conclusion: Clinical trials have demonstrated that ciclosporin minimizes the signs and symptoms of dry eye disease and is not associated with any significant systemic or ocular adverse reaction.     

Emerging therapies in allergic conjunctivitis and dry eye syndrome

Introduction: Inflammatory disorders of the anterior surface of the eye consist of a spectrum of disorders that range from ocular allergy, dry eye syndrome (DES), and various infections. They exhibit similar pathological profiles, but have divergent immune mechanisms with some overlap. A number of novel treatments are currently being studied that capitalize on the growing understanding of underlying immunopathophysiology.

Areas covered: The goal of this review is to examine the emerging pipeline for noninfectious inflammatory disorders of the anterior surface of the eye – primarily allergic conjunctivitis (AC) and DES – in light of the recent basic science discoveries that have fueled their development. Novel molecules for the treatment of AC and DES from clinicaltrials.gov as well as recently filed patents for new molecular entities were reviewed from PUBMED and OVID.

Expert opinion: Significant progress toward targeted treatments for AC and DES has become increasingly reliant on understanding the immunomodulatory and inflammatory mechanisms of the conjunctiva.