强脉冲光治疗上下睑对睑板腺功能障碍患者眼表及视觉质量的影响  

Effects of intense pulsed light therapy on upper and lower eyelids on ocular surface and visual quality in patients with meibomian gland dysfunction

作　　者：张奥 肖风琪 顾正宇[1] 叶敏捷[1] 廖荣丰[1] Zhang Ao;Xiao Fengqi;Gu Zhengyu;Ye Minjie;Liao Rongfeng(Department of Ophthalmology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Ophthalmology,the Third People’s Hospital of Changzhou,Changzhou 213001,China)

机构地区：[1]安徽医科大学第一附属医院眼科,合肥230022 [2]常州市第三人民医院眼科

出　　处：《临床眼科杂志》2022年第4期339-343,共5页Journal of Clinical Ophthalmology

摘　　要：目的应用Keratograph 5M眼表综合分析仪和欧卡斯双通道视觉质量分析系统(OQASⅡ)观察对比强脉冲光(IPL)同时治疗上下睑与仅治疗下睑的治疗效果。方法前瞻性随机双盲自身对照研究。选取中重度睑板腺功能障碍(MGD)患者20例(40只眼),上下睑组20只眼,给与IPL同时治疗上下睑(每两周1次,共3次)。对照组20只眼,给予IPL治疗下睑(每两周1次,共3次)。记录首次治疗前(基线)及首次治疗后2、4、6周时患者的眼表疾病指数(OSDI)、非侵入平均泪膜破裂时间(NI-BUTave)、平均客观散射指数(mean OSI)等数据,评估两种治疗方法的有效性、安全性以及疗效对比。结果两组治疗前各观察指标无差异(P>0.05)。从指标改善上看,上下睑组的指标改善时间较对照组早。治疗后6周,两组的OSDI评分均得到有效改善,但上下睑组与对照组的OSDI评分并无区别(P>0.05)。两组的NI-BUTave、mean OSI在治疗后均得到有效改善且在治疗后6周,两组间的NI-BUTave差异有统计学意义(P<0.05)。两组在治疗后并未发现不可逆的眼睑皮肤损伤。结论强脉冲光同时治疗上下睑与仅治疗下睑两种治疗方法对中重度MGD的治疗均是安全的,有效的,且同时治疗上下睑相较于仅治疗下睑起效更快,治疗效果更好。Objective To observe and compare the effects of intense pulsed light(IPL)on the upper and lower eyelids and on the lower eyelids by using the keratograph 5M ocular surface integrated analyzer(K5M)and the dual-channel visual quality analysis system(OQASⅡ).Methods This study was a single-center,prospective,randomized,double-blind,self-controlled clinical study.A total of 20 patients(40 eyes)with moderate to severe meibomian gland dysfunction(MGD)were selected.The upper and lower eyelids group were treated with IPL on the upper and lower eyelids(once every two weeks,3 times in total).The control group were treated with IPL on the lower eyelids(once every two weeks,3 times in total).The patient’s ocular surface disease index(OSDI),non-invasive mean tear film rupture time(NIBUTave),average objective scattering index(mean OSI)and other data before the first treatment(baseline)and 2,4,and 6 weeks after the first treatment were recorded to evaluate the safety and efficacy of the two treatments.Results There was no significant difference in the observation indexes between the two groups before treatment(P>0.05).From the improvement rate,the changes in the upper and lower eyelids group was earlier than that of the control group.6 weeks after treatment,the OSDI scores of the two groups were significantly improved,but there was no difference between the upper and lower eyelids group and the control group(P>0.05).The NIBUTav and mean OSI of the two groups were significantly improved,and at 6 weeks after treatment,the difference in NIBUTav between the two groups was statistically significant(P<0.05).No irreversible eyelid skin damage was found in the two groups after treatment.Conclusions The two treatments of intense pulsed light are safe and effective for moderate to severe MGD.The effective time and curative effect of the IPL on the upper and lower eyelids are better than that of the IPL on the lower eyelids only.

关 键 词：睑板腺功能障碍 双通道技术 强脉冲激光 视觉质量 

分 类 号：R777.13[医药卫生—眼科]