ABSTRACT
@#AIM:To observe and compare the therapeutic effects of intense pulsed light(IPL)combined with meibomian gland massage and eyelid fumigation massage on dry eyes associated with meibomian gland dysfunction(MGD).<p>METHODS: This study was a prospective randomized controlled clinical trial. Totally 73(146 eyes)outpatients with MGD-related dry eyes were selected from March 2018 to August 2018 at Xi'an No.4 Hospital. 38 patients(76 eyes)in the experimental group were given IPL combined meibomian gland massage treatment(once every three weeks, three times in all), and 35 patients(70 eyes)in the control group were given eyelid fumigation combined meibomian gland massage treatment(fumigating and cleaning the eyelid margin every day for 5d, massaging the tarsal gland on the fifth day, repeating treatment after 2wk, totally 3 times). The study lasted 12wk. The ocular surface disease index(OSDI), standard dry eye assessment questionnaire(SPEED), non-invasive tear film rupture time(NITBUT), non-invasive lacrimal river height measurement(NITMH), meibomian gland loss score(MGS), meibomian gland secretion assessment(MGYSS)before and after the first treatment, the first week, the fourth week, the seventh week and the twelfth week were recorded to evaluate the curative effect of the two treatments.<p>RESULTS: There was no significant difference in gender and age between the two groups(<i>P</i>>0.05).There was no significant difference in data between the two groups before treatment(<i>P</i>>0.05). Indexes except NITMH and MGS each time point after treatment in the two groups were significantly improved compared with those before treatment, and the difference was statistically significant(<i>P</i><0.05). There was no significant difference in each index between the experimental group and the control group at 1wk after treatment(<i>P</i>>0.05); at 4, 7 and 12wk after treatment, the experimental group was superior to the control group except for NITMH and MGS, and the difference was statistically significant(<i>P</i><0.05). From the change trend of the indicators, the therapeutic effect of the experimental group continued to improve after the first treatment, and was the best at the 12th week, while that of the control group was the best at the 7th week after the first treatment, and then the curative effect was weakened. There were no obvious complications in both groups after treatment.<p>CONCLUSION: Both intense pulsed light combined with palpebral gland massage and eyelid fumigation massage are convenient, safe and effective for MGD-related dry eyes, and the curative effect and maintenance time of intense pulsed light combined with palpebral gland massage are better than that of eyelid fumigation massage.
ABSTRACT
@#AIM: To observe the treatment effect and discuss availability of spherical retinal detachment by 23G intra-infusion-assisted scleral buckling. <p>METHODS: Twenty-one eyes were randomly selected from in-patients with rhegmatogenous retinal detachment with much subretinal fluid and spherical appearance between February 2017 and February 2018, which were suitable for scleral buckling. The 23G intra-infusion was placed in the pars plana of ciliary body before the surgery. Retinal hole was not solidified during operation. Laser photocoagulation was performed around the retinal hole after surgery. Retinal reattachment state and the complications were evaluated by 3 to 10mo follow up. <p>RESULTS: All patients have undergone operations smoothly. Subretinal fluid was drainage, chroidal bleeding and retinal incarceration did not appear during the operation. Eighteen eyes achieved retinal reattachment on the first postoperative day; Subretinal fluid of two eyes was asorbed fully; One eyes achieved retinal reattachment after the adjustment by the external pressure block. One eyes with recurrence achieved retinal reattachment after vitreoretinal surgery. One eye developed complication with subretinal hemorrhage and the range of bleeding was less than 1PD, which was absorbed after 3mo. There were no eyes found abnormal intraocular pressure, anterior segment ischemia or other sever complications.<p>CONCLUSION: The 23G intra-infusion was pre-placed before relieving fluid in the scleral buckling of retinal detachment, which can effective keep intraocular pressure stably and reduce the possibilities of explosive suprachoroidal hemorrhage and postoperative choroidal amotio triggered by fast decrease of intraocular pressure. The retina is flat basically and the hole location is relatively accurate, which improve the success of the surgery.