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AIM:To explore the efficacy of intense pulsed light combined with meibomian gland massage and diquafosol eye drops in lipid deficiency dry eye disease and related cytokines.METHODS: A total of 511 patients(1 022 eyes)with lipid deficiency dry eye diagnosed in the ophthalmology clinic of our hospital from January to December 2021 were selected as the research objects. They were divided into two groups according to the patient's wishes: 294 cases(588 eyes)in the study group were treated with diquafosol sodium eye drops combined with intense pulsed light and meibomian gland massage, while 217 cases(434 eyes)in the control group were treated with artificial tears combined with intense pulsed light and meibomian gland massage. The levels of tear tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β)and lactoferrin(LF)before and after treatment were detected, the corneal fluorescein staining(CFS)score, tear film break-up time(BUT), and Schirmer Ⅰ(SⅠt)under no surface anesthesia, ocular surface disease index(OSDI)were compared, the correlation between TNF-α, IL-1β, LF levels and CFS, BUT, SⅠt, OSDI before treatment was analyzed, and the occurrence of adverse reactions was observed.RESULTS: There was no significant difference in preoperative OSDI, SⅠt, BUT, CFS and levels of TNF-α, IL-1β and LF between the two groups(P>0.05). The SⅠt, BUT, CFS and levels of TNF-α, IL-1β and LF in the study group at 3, 6 and 9wk after treatment were better than those of control group(P<0.05). There were no differences in OSDI score of both groups at 9wk after treatment(P>0.05). The TNF-α and IL-1β were negatively correlated with SⅠt and BUT, while they were positively correlated with CFS and OSDI; LF and SⅠt were positively correlated with SⅠt and BUT, while they were negatively correlated with CFS and OSDI(all P<0.01); The adverse reaction rate of the study group(5.78%)was significantly lower than that of the control group(11.52%; P<0.05).CONCLUSION: Intense pulsed light combined with meibomian gland massage and diquafosol sodium eye drops is effective and well tolerated in the treatment of lipid deficiency dry eye.
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@#AIM:To investigate the clinical effect of ultrasonic atomization of Shenmai Runmu formula on dry eyes related to meibomian gland dysfunction(MGD). <p>METHODS: Totally 120 cases of MGD related dry eye patients in our hospital patients were randomly divided into two groups: treatment group(ultrasonic atomization of Shenmai Runmu group)and control group(OPT intense pulse phototherapy), 60 cases each, both groups were combined with meibomian gland massage. The ocular surface comprehensive analyzer was used to detect various indicators: average non-invasive tear break-up time(NITBUTav), lower tear meniscus height(LTMH), meibomian gland score, <i>etc</i>. Subjective symptoms of patients' eyes were scored by questionnaire survey, and the clinical data were statistically processed. <p>RESULTS: There was no statistical difference between the treatment group and the control group in terms of gender, age, course of disease before treatment, and the indicators in the period from treatment start to 6mo after the treatment end(<i>P</i>>0.05); The total effective rate was about 94.9% in the treatment group and 96.6% in the control group(<i>P</i>>0.05). <p>CONCLUSION: Ultrasonic atomization combined with meibomian gland massage can improve the subjective symptoms and objective indexes of MGD related dry eyes. Compared with the modern medical treatment, the therapeutic effect of this method is basically the same, safe and effective, but it is more convenient and economic, which is worth popularizing in clinical application.
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@#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.
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@#AIM: To compare the clinical curative effects of meibomian gland dysfunction(MGD)caused by evaporative dry eye by utilizing levofloxacin eye gel and Tobramycin and Dexamethasone Ophthalmic Ointment, respectively.<p>METHODS: The 180 cases(360 eyes)with dry eye(evaporative type)caused by confirmed meibomian gland dysfunction were randomly divided into two groups(<i>i.e.</i> A and B): In group A, 90 individuals with 180 eyes were treated with levofloxacin eye gel+ sodium hyaluronate eye solution; The other 90 cases in group B took Tobramycin and Dexamethasone Ophthalmic Ointment+ sodium hyaluronate eye drops for curing the MGD. In addition, the same comprehensive therapy were used to the MGD patients in groups A and B, after surface anesthesia on binoculus, secretion, obstructing meibomian gland secretions, were discharged by utilizing cotton stick to extrusion mass weekly and four times consecutive treatments were regard as a course of treatment. To remove residual the thin oil soften lipid in meibomian gland, heat can be applied to the eyelids with hot water(around 45℃)on towel for 15min and do that three times a day. After each hot compress, we use levofloxacin eye gel to the patients in group A by dropping into the conjunctival sac and apply to the root of the eyelid lashes. The group B of 90 patients were applied Tobramycin and Dexamethasone Ophthalmic Ointment to the root of the eyelid lashes. All patients were dripped odium eye drops eye into their eyes four times a day. <p>RESULTS: After treatment(<i>Z</i>= -0.64, <i>P</i>=0.524), there were no significant differences in clinical symptoms(<i>Z</i>= -1.37, <i>P</i>=0.171), secretion characteristics(<i>Z</i>= -1.06, <i>P</i>=0.288), tear film rupture time and tear secretion time between groups A and B(<i>P</i>>0.05). Corneal fluorescence staining score: group A(cured 83.3%, improved 11.1%, ineffective 5.6%)and group B(cured 55.6%, improved 27.8%, ineffective 16.7%). The therapeutic effect of group A was better than that of group B, with statistical significance(<i>Z</i>= -4.02, <i>P</i><0.001).<p>CONCLUSION: Physical therapy for meibomian gland dysfunction caused by evaporative dry eye is given priority, and medication is treated as adjunctive therapy. Generally, the patients can achieve totally anti-inflammatory, antibacterial, safe and stable, without side effects by using levofloxacin eye gel. However, the patients with worst condition and lingering illness should cured by Tobramycin and Dexamethasone Ophthalmic Ointment. In addition, statistical significant difference is not found between the two drugs on curative effects.
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?AIM:To study the changes of ocular surface in cataract patients with Meibomian gland dysfunction ( MGD) who treated with Meibomian gland massage before surgery.?METHODS: Totally 90 patients ( 93 eyes ) with cataract and MGD were randomly divided into two groups. Patients in experimental group were treated with hot compress and Meibomian gland massage every day before surgery, while the patients in the control group were not taken. Two groups of patients received phacoemulsification combined with intraocular lens implantation. Lid margin abnormalities, secretion characteristics, Schimer I test ( SⅠt) and tear film break-up time ( BUT ) were recorded and compared between two groups using slit lamp microscope inspection preoperatively and postoperatively 1wk.?RESULTS:In the control group, the postoperative score of eyelid margin and Meibomian gland secretion was increased significantly than preoperative, while the value of BUT and SⅠt was down significantly. Compared with control group, the postoperative score of eyelid margin shape and Meibomian gland secretion in the experimental group was decreased significantly, while the value of BUT and SIT improved significantly (P<0. 05).?CONCLUSION: Phacoemulsification can aggravate the Meibomian gland dysfunction and have some extent of effects on the ocular surface. Meibomian gland massage before surgery can significantly improve the function of Meibomian gland and the state of ocular surface in patients with MDG.