可吸收泪小管塞栓联合人工泪液治疗中重度干眼的有效性及对视觉相关生存质量的影响

目的 评估可吸收泪小管塞栓联合人工泪液治疗中重度干眼的有效性及对视觉相关生存质量的影响。 方法 选择干眼患者32例(64眼),所有患者分为两组,使用人工泪液治疗16例患者为对照组,使用泪小管塞栓联合人工泪液治疗16例患者为试验组,对比评价两组治疗前以及治疗后1个月、3个月和5个月的泪膜破裂时间、泪液分泌试验、角膜荧光染色评分、主观症状评分及视觉相关生存质量(VRQOL)评分。 结果 治疗前泪膜破裂时间(P=0.803)、泪液分泌试验(P=0.758)、角膜荧光染色评分(P=0.735)、主观症状评分(P=0.385)及视觉相关生存质量(VRQOL)评分(P=0.883),两组各项指标差异均无统计学意义;而在治疗后五项指标1个月(P<0.001)、3个月(P<0.001)及5个月(P<0.001),两组间各项指标较治疗前差异均有统计学意义,且试验组的指标改善较对照组更为明显,除治疗后5个月的泪液分泌试验(P=0.141)无统计学意义,其他指标治疗后1个月(P<0.001)(<0.001)(<0.001)(0.014)(<0.001)、3个月(P<0.001)(0.007)(<0.001)(<0.001)(<0.001)、5个月(P<0.001)(0.141)(<0.001)(<0.001)(<0.001)指标差异均有统计学意义。 结论 可吸收泪小管塞栓联合人工泪液治疗可以明显改善中重度干眼患者的临床症状,提高患者视觉相关生存质量。

Effect of absorbable lacrimal plug combined with artificial tears on the treatment of moderate to severe dry eye and its impact on vision-related quality of life

Objective To evaluate the effect of absorbable lacrimal plugs combined with artificial tears on the treatment of moderate to severe dry eye and assess its impact on vision-related quality of life. Methods In total, 32 patients(64 eyes)diagnosed as having moderate to severe dry eye were enrolled. All patients were randomly divided into two groups; one group received absorbable lacrimal plugs combined with artificial tears, whereas the other one received only artificial tears for routine treatment. Schirmer's test results, tear film break-up time, corneal fluorescein staining, personal symptom and vision-related quality of life scores before and at 1, 3, and 5 months after treatment were analyzed and compared between the groups. Results There were no significant between-group differences in tear film break-up time(P=0.803), Schirmer's test results(P=0.758), corneal fluorescein staining(P=0.735), personal symptom(P=0.385)and vision-related quality of life scores(P=0.883)before treatment. Both groups exhibited significant improvements in all the observed parameters at 1 month(P<0.001), 3 month(P<0.001), and 5 month(P<0.001)after treatment. However, the experimental group exhibited significantly better improvement than the control group in all parameters, except for the Schirmer's test results at 5 months after treatment(P=0.141),the other parameters at 1 month(P<0.001)(<0.001)(<0.001)(0.014)<0.001), 3 month(P<0.001)(0.007)(<0.001)(<0.001)(<0.001), and 5 month(P<0.001)(0.141)(<0.001)(<0.001)(<0.001)were significant differences. Conclusion Treatment with absorbable lacrimal plugs combined with the application of artificial tears evidently alleviated symptoms and improved vision-related quality of life in patients with moderate to severe dry eye.