佩戴角膜绷带镜对轻度MGD患者白内障术后干眼防治的安全性及有效性  

Safety and effectiveness of corneal bandage lens for the prevention and treatment of dry eye after cataract surgery in patients with mild meibomian gland dysfunction

作　　者：潘彦丽 梁艳[2] 李元彬[2] Pan Yanli;Liang Yan;Li Yuanbin(School of Clinical Medicine,Weifang Medical University,Weifang 261053,China;Department of Ophthalmology,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai 264000,China)

机构地区：[1]潍坊医学院临床医学院,潍坊261053 [2]青岛大学附属烟台毓璜顶医院眼科,烟台264000

出　　处：《中华实验眼科杂志》2022年第5期448-453,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：山东省自然科学基金项目(ZR2017LH043);烟台市科技发展计划基金项目(2021YD025)。

摘　　要：目的评价角膜绷带镜防治轻度睑板腺功能障碍(MGD)患者白内障术后干眼的有效性和安全性。方法采用非随机对照临床研究方法,纳入2020年6月至2021年2月于烟台毓璜顶医院眼科行超声乳化白内障摘出联合人工晶状体(IOL)植入手术的白内障合并轻度MGD患者60例60眼,根据患者意愿将其分为绷带镜佩戴组和对照组,每组30眼,其中绷带镜佩戴组术眼术后连续佩戴角膜绷带镜14 d,第14天复查时取出;对照组术眼术毕未佩戴角膜绷带镜,2个组术眼术后用药均一致。术前及术后第1、7、14天,采用裂隙灯显微镜观察眼前节结构及炎症表现;采用标准对数视力表获得最佳矫正视力(BCVA);采用眼表疾病指数(OSDI)问卷对术眼眼表症状进行评分;采用眼表综合分析仪评估术眼睑板腺情况并记录非侵入性首次泪膜破裂时间(NIFBUT);采用角膜荧光素钠染色(CFS)观察术眼角膜上皮有无缺损并对角膜着色情况进行评分。结果术后第1、7、14天,2个组术眼均未出现炎症反应及并发症;术后不同时间点BCVA总体比较差异有统计学意义(F_(时间)=3.610,P=0.016),其中各组术后第7天BCVA较术后第1天提高,术后第14天BCVA较第1天和第7天明显提高,差异均有统计学意义(均P<0.05)。2个组术后不同时间点OSDI评分总体比较差异均有统计学意义(F_(组别)=31.219,P<0.001;F_(时间)=15.672,P<0.001),其中2个组术后第7天和第14天绷带镜佩戴组OSDI评分明显低于对照组,术后第14天OSDI评分均明显低于术后第1天和第7天,差异均有统计学意义(均P<0.05)。对照组术后第7天和第14天术眼NIFBUT值分别为(6.62±0.93)s和(8.02±1.13)s,绷带镜佩戴组分别为(9.81±0.91)s和(10.03±0.49)s,2个组总体比较差异有统计学意义(F_(组别)=2.351,P=0.037),其中术后第7天和第14天绷带镜佩戴组NIFBUT值均高于相应时间点对照组,差异均有统计学意义(均P<0.05)。对照组术后第7天和第14天高CFS评�Objective To evaluate the efficacy and safety of corneal bandage lens in the treatment of dry eye after cataract surgery in patients with mild meibomian gland dysfunction(MGD).Methods A non-randomized controlled clinical study was conducted.Sixty eyes of 60 patients with mild MGD after cataract surgery were enrolled in Yantai Yuhuangding Hospital from June 2020 to February 2021.The patients were divided into bandage lens group and control group according their willingness,with 30 eyes in each group.All the patients received phacoemulsification and intraocular lens implantation and were administered with the same postoperative medication.Patients in bandage lens group wore lenses for 14 days continuously after the operation.Patients in control group did not wear the corneal bandage lens after the operation.The structure and inflammation of the anterior segment were observed with a slit-lamp microscope before operation and on days 1,7,and 14 after the operation.Best corrected visual acuity(BCVA)was obtained using a standard logarithmic visual acuity chart.Ocular surface symptoms were evaluated via an ocular surface disease index(OSDI)questionnaire.The intraoperative changes of meibomian glands were assessed with an ocular surface analyzer and the non-invasive first tear film break-up time(NIFBUT)was recorded.Corneal epithelium defects were observed by corneal fluorescein sodium staining(CFS).This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Yantai Yuhuangding Hospital(No.2021-363).Written informed consent was obtained from each patient before any medical examination.Results On the 1st,7th,and 14th day after surgery,no inflammatory reaction or complication was observed in both groups.Statistically significant differences in BCVA among different postoperative time points were found(F_(time)=3.610,P=0.016).BCVA on the 7th day after surgery were higher than that on the 1st day after surgery,and the BCVA on the 14th day after surgery were significantly higher than those on the

关 键 词：睑板腺功能障碍 角膜绷带镜 干眼 白内障超声乳化术 疗效 

分 类 号：R779.6[医药卫生—眼科]