Clinical study of the treatment of lid-wiper epitheliopathy / 眼科研究

ABSTRACT

Objective Current research proposed that lid-wiper epitheliopathy may be a early symptom of dry eye.At present,there are seldom studies on lid-wiper epitheliopathy in both home and abroad.This study was to investigate the effect of artificial tears without antiseptic in the treatment of lid-wiper epitheliopathy and discuss the method of treatment of lid-wiper epitheliopathy. MethodsThis is a case-observative study.Seventy patients with lid-wiper epitheliopathy and with negative results in tear film break-up test,SchirmerⅠtest and corneal fluorescine staining were enrolled in the Peking University First Hospital during September 2006 and June 2008.The treatment group included 54 eyes of 54 patients who received topically free-antiseptic artificial tears (dextran 70 eye drops) four times per day for two weeks,and the control group included 16 eyes from 16 patients who were not treated.Dry Eye Questionnaire were taken from the patients before the administration of drug and 2 weeks after treatment.Fluorescein and Lissamine green double-staining was used before and after treatment for the evaluation of lid-wiper epitheliopathy.The disease was graded into 0 (absence) to 3(severe),and the symptoms and dye were scored following the Standard Patient Evaluation of Eye Dryness (Korb criteria).Informed consent and good compliance were obtained before initial and during the therapy duration. ResultsIn the treatment group,the scores of symproms and staining were significantly different between before and after administration of drug (12.91±2.55 vs 2.78±2.27 in symptom,t=22.70,P＜0.05;1.79±0.78 vs 0.19±0.31 in dye,Z=-6.40,P＜0.05),indicating the symptoms and dye results were obviously improved after therapy.In the control group,no significant differences were found in the symptom score and dye score in the corresponding time period (12.63±2.60 vs 12.94±2.11,t=-1.10,P＞0.05 in symptom;1.97±0.74 vs 1.98±0.72,Z=-0.58,P＞0.05 in dye).According to the grade of disease,the magnitude of the staining after treatment was considerably improved in comparison with before treatment (Z_1=-3.47 for mild,Z_2=-4.04 for moderate,Z_3=-3.74 for severe),showing statistically significant differences between them (P＜0.05).ConclusionThe use of artificial tears is an efficacious treatment for treating lid wiper epitheliopathy.The topicaly utilization of artificial tears can alleviate the symptoms and pathological changes of lid wiper epitheliopathy.