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山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (4): 54-60.doi: 10.6040/j.issn.1671-7554.0.2024.0148

• 临床医学 • 上一篇    

强脉冲光治疗对脂质异常型干眼睑板腺及泪膜脂质层的影响

张琪晨1,康随芳1,殷钏杰2,肖娟3,马广凤1,曹媛1,陈国玲1   

  1. 1.山东大学第二医院眼科, 山东 济南 250033;2.青岛市第八人民医院眼科, 山东 青岛 266100;3.山东大学第二医院医院感染管理部, 山东 济南 250033
  • 发布日期:2024-05-16
  • 通讯作者: 陈国玲. E-mail:cgl6129@163.com

Effects of intense pulsed light on the meibomian gland and tear film lipid layer in patients with lipid deficiency dry eye disease

ZHANG Qichen1, KANG Suifang1, YIN Chuanjie2, XIAO Juan3, MA Guangfeng1, CAO Yuan1, CHEN Guoling1   

  1. 1. Department of Ophthalmology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Department of Ophthalmology, Qingdao Eighth Peoples Hospital, Qingdao 266100, Shandong, China;
    3. Department of Hospital Infection Management, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2024-05-16

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摘要： 目的 观察强脉冲光(intense pulsed light, IPL)治疗对脂质异常型干眼患者睑板腺及泪膜脂质层的影响。 方法 采用随机数字的方法将60例(120眼)脂质异常型干眼患者分为对照组(60眼)及IPL组(60眼)。两组患者均于治疗前及治疗6周后使用非接触式泪膜破裂时间(non-invasive breakup time, NIBUT)、眼表疾病指数(ocular surface disease index, OSDI)问卷调查及角膜荧光素染色(corneal fluorescein staining, CFS)评估干眼相关指标;采用Oculus Keratograph眼表分析仪及睑板腺评估仪(meibomian gland evaluator, MGE)检测睑板腺缺失程度(meibomian gland dropout score, MGDS)、睑板腺排出能力(meibomian gland yielding liquid secretion, MGLYS)及睑酯性状(meibomian gland yielding secretion score, MGYSS)评估睑板腺相关指标;使用LipiView眼表面干涉仪评估泪膜脂质层厚度(lipid layer thickness, LLT)。 结果 两组患者基线特征差异无统计学意义。与治疗前相比,两组患者治疗后的NIBUT、OSDI、CFS、MGLYS、MGYSS及LLT均有不同程度的改善(P均<0.001),MGDS差异均无统计学意义。IPL组与对照组的MGDS差异无统计学意义,IPL组中其余指标改善均更明显(PNIBUT=0.031,POSDI=0.023,PCFS=0.014,PMGLYS=0.020,PMGLYS=0.023,PLLT=0.004)。治疗过程中,两组均未发生不良反应。 结论 IPL治疗能有效改善脂质异常型干眼患者的睑板腺功能、增加泪膜脂质层厚度。

关键词: 脂质异常型干眼, 强脉冲光, 睑板腺, 泪膜稳定性, 眼表疾病

Abstract: Objective To observe the effects of intense pulsed light(IPL)on the meibomian gland and tear film lipid layer in patients with lipid deficiency dry eye disease. Methods A total of 60 patients(120 eyes)with lipid deficiency dry eye disease were divided into control group(60 eyes)and IPL group(60 eyes)using random numbers. Before and after 6 weeks of treatment, non-invasive breakup time(NIBUT), ocular surface disease index(OSDI)questionnaire, and corneal fluorescein staining(CFS)were assessed to evaluate the indicators of dry eye disease. The Oculus Keratograph analyzer and meibomian gland evaluator(MGE)were used to determine the meibomian gland dropout score(MGDS), meibomian gland yielding liquid secretion(MGLYS)and meibomian gland yielding secretion score(MGYSS)to assess the meibomian gland. The LipiView interferometer was used to evaluate the tear film lipid layer thickness(LLT). Results No statistically significant differences were observed between the two groups before treatment. Compared with baseline, NIBUT, OSDI, CFS, MGLYS, MGYSS and LLT were improved in both groups after treatment(all P<0.001), while there was no significant difference in MGDS. Except MGDS, the other parameters in the IPL group were improved better than those in control group after treatment(PNIBUT=0.031, POSDI=0.023, PCFS=0.014, PMGLYS=0.020, PMGLYS=0.023, PLLT=0.004). No adverse reactions occurred during the treatment. Conclusion IPL could improve the function of meibomian gland and the thickness of tear film lipid layer; it is an effective and safe treatment for patients with lipid deficiency dry eye disease.

Key words: Lipid deficiency dry eye disease, Intense pulsed light, Meibomian gland, Tear film stability, Ocular surface disease

中图分类号: 

  • R777.1+3
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[1] 范梦娇,何勤,罗青,王振华. 反射式共聚焦显微镜观察强脉冲光治疗红斑毛细血管扩张型玫瑰痤疮的效果[J]. 山东大学学报 (医学版), 2022, 60(4): 87-90.
[2] 张京京,陈国玲,鲍印磊,马广风. Oculus Keratograph分析仪评估睑板腺功能障碍患者的眼表情况[J]. 山东大学学报 (医学版), 2020, 58(6): 87-91.
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