RESUMO
PURPOSE: To evaluate the effectiveness of complex treatment, including eyelid hygiene, on the condition of ocular surface in dry eye patients before cataract surgery. MATERIAL AND METHODS: The study included 56 female age-related cataract patients (64±4.3 years old) with dry eye caused by Meibomian gland dysfunction (MGD). The main group patients (n=28) underwent eyelid hygiene therapy (2 times a day, 1 month) that involved Blefarogel cleansing, Blefarolotion, Blefarogel-1. The main and control (n=28) group patients performed (during the month): «fat-water¼ type nanoemulsion instillation (3 times a day); preservative free vitamin-A application (at night). Methods included dry eye symptoms assessment (OSDI scale); TBUT; Shirmer-1 test; lissamine green vital staining with xerosis indicator calculation (van Bijsterveld scale); "lid wipers" symptom evaluation; Norn compression test. Statistical evaluation included: mean and standard deviation calculation (M±s); significance of differences assessment (Mann-Whitney U-test; Wilcoxon's T-test). RESULTS: The main group patients (artificial tear, keratoprotection, eyelid hygiene) showed a statistically significant more pronounced decrease in OSDI (from 33.2±3.1 points to 15.2±1.8 points) and a significantly more pronounced increase in TBUT (from 4.8±0.5 s to 6.9±0.4 s) than in control group patients (artificial tear, keratoprotection; respectively, from 32.7±3.2 to 20.8±3.1 points and from 4.85±0.5 to 5.8±0.4 s; p<0.05). Apparently, this was associated with a significantly more pronounced relief of the MGD signs in main group patients (from 2.1±0.1 to 1.1±0.2 points; p<0.05) as a result of eyelid hygiene. In the control group, the dynamics of MGD severity (from 2.08±0.3 to 2.11±0.5 points) was statistically insignificant. CONCLUSION: Eyelid hygiene (based on Blefarogel cleansing, Blefarolotion, Blefarogel-1) increases the effectiveness of dry eye treatment in MGD patients, compared with isolated tear substitution and keratoprotection.
