Effect Of Preoperative Physical Therapy On Ocular Surface Of Cataract Patients Complicated By Meibomian Gland Dysfunction

Objective:In order to evaluate the treatment efforts of physical therapy before surgery on postoperative ocular surface of cataract patients combined with meibomian gland dysfunction（MGD）.Method:Prospective clinical observation from December 2019to December 2020.A total of 118 cataract patients with meibomian gland dysfunction were incorporated into the observation from the Affiliated TCM Hospital of Xinjiang Medical University.Fifty-nine patients underwent preoperative physical therapy,whereas fifty-nine patients were divided into control group.The control group used 0.5%levofloxacin eye drops 4 times a day 1-3 days before operation,and the lacrimal passages and conjunctival sac were irrigated one day before the operation;Preoperative physical therapy group:physical therapy of meibomian glands（Chinese medicine packet hot compress,meibomian gland massage,cold compress）was given one day prior to surgery,and other treatments done as usual.The differences of OSDI,TBUT,SIT,CFS and meibomian gland scores between the two groups were observed and recorded before treatment and one week,one month and three months after operation.Results:Before and after operation,compared with OSDI and TBUT in the control group,intergroup(OSDI:F _{within-subject}=167.308,P<0.001;TBUT:F _{within-subject}=19.794,P<0.001),intragroup(OSDI:F _{between-subject}=123.932,P<0.001;TBUT:F _{between-subject}=13.898,P<0.001),interaction(OSDI:F _interaction=119.286,P<0.001;TBUT:F _interaction=9.323,P<0.001)were statistically significant.Compared with SIT and meibomian gland score in the control group,intragroup(SIT:F _{between-subject}=2.958,P=0.035;meibomian gland score:F _{between-subject}=3.729,P=0.013)were statistically significant,and there were no statistically significant differences between groups in intergroup(SIT:F _{within-subject}=0.420,P=0.518;meibomian gland score:F _{within-subject}=0.131,P=0.718),interaction(SIT:F _interaction=0.349,P=0.790;meibomian gland score:F _interaction=1.101,P=0.352).Compared with CFS in two groups,results showed statistically significant differences in intragroup(F _{between-subject}=14.935,P<0.001),interaction(F _interaction=4.769,P=0.004),and there was no statistically significant difference between groups(F _{within-subject}=2.449,P=0.137).Conclusions:Preoperative MGs physiotherapy for cataract patients with MGD can improve OSDI and enhance tear film stability,which is conducive to the prevention and treatment of ocular surface diseases after cataract surgery.