Study on the short-term efficacy of intense pulsed light in the treatment of moderate and severe meibomian gland dysfunction-related dry eyes and its effect on patients' psychological condition / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#AIM: To evaluate the short-term efficacy and its impact on psychological status in patients with moderate to severe MGD-related dry eye in the treatment of intense pulse laser(IPL).<p>METHODS:The situations before and after of oneself were compared. From October 2018 to October 2019, 25 patients(50 eyes)with moderate to severe MGD who were admitted to the Ophthalmology Development of Wuhan University People's Hospital were collected. They were given intense pulse laser combined with meibomian gland massage therapy. Before the treatment and one month after the one course of treatment, the changes in symptoms, signs, and mental status of patients were evaluated. The ocular surface disease index(OSDI)questionnaire scoring criteria were used to assess patients' symptoms. Through tear secretion test(S I t), tear meniscus height, mean tear break-up time(Mean BUT), meibomian gland loss degree, and mean scattering index(Mean OSI)measured by Ocassian dual-channel system, the signs of patients were evaluated. By using the Self-Rating Anxiety Scale(SAS)and the center for epidemiological studies depression scale(CES-D), the mental state of the patients was evaluated.<p>RESULTS: The results of the patients before and after treatment were as follows, OSDI score(58.36±10.34 <i>vs </i>49.12±8.05), SⅠt(5.64±1.6 <i>vs </i>8.24±1.71mm/5min), tear meniscus height(0.19±0.04 <i>vs</i> 0.23±0.04mm), Mean BUT(5.65±1.72 <i>vs</i> 7.06±1.84s), Mean OSI(0.89±0.24<i> vs</i> 0.75±0.23), meibomian gland loss degree score(2.56±0.58 <i>vs</i> 1.84±0.85), SAS score(46.92±8.49 <i>vs</i> 40.2±8.01), CES-D score(21.04±6.11 <i>vs</i> 16.92±4.24), all indicators had statistical significance(<i>P</i><0.01). OSDI score was negatively correlated with Mean BUT(<i>r</i>s=-0.511,<i> P</i><0.01), and positively correlated with Mean OSI(<i>r</i>s=0.479, <i>P</i><0.05). OSDI score was positively correlated with SAS score and CES-D score(<i>r</i>s=0.775, 0.856, <i>P</i><0.01). SAS score was negatively correlated with SⅠt and Mean BUT(<i>r</i>s= -0.653, -0.713,<i> P</i><0.01). SAS was positively correlated with CES-D score(<i>r</i>s=0.730, <i>P</i><0.01).<p>CONCLUSION: IPL is safe and effective for short-term observation of moderate to severe MGD-related dry eye. After treatment, the dry eye symptoms, signs and mental state of patients can be relieved with different degrees. There is the correction between the depression and anxiety of patients and ocular surface symptoms.