| Objective: The effect of preoperative fumigation with Huanglian Jiedu decoction combined with lid gland massage on the postoperative ocular surface of patients with age-related cataract combined with meibomian gland dysfunction dry eye was assessed by tear break-up time,corneal fluorescein staining score,Schirmer Ⅰ test,ocular surface disease index,lid margin morphology,the ability of the meibomian gland to expel secretions,lid fat quality of the lid glands.Methods: A total of 120 patients(120 eyes)with age-related cataract combined with meibomian gland dysfunction dry eye were selected from the Department of Ophthalmology of the Affiliated Hospital of Changchun University of Traditional Chinese Medicine between2021 December to November 2022,120 cases(120 eyes)were randomly divided into Treatment Group 1,Treatment Group 2 and control group according to the method of random grouping,each group had 40 cases(40 eyes).Treatment 1 group: fumigation with Huanglian Jiedu decoction combined with lid gland massage twice at 1 week and 3 days before surgery;Treatment 2 group: fumigation with distilled water combined with lid gland massage twice at1 week and 3 days before surgery;Control group: a blank control group with no treatment before surgery.The tear break-up time(BUT),corneal fluorescein staining(FL),Schirmer Ⅰtest(SIt),lid margin morphology,the ability of the meibomian gland to expel secretions,lid fat quality of the lid glands were recorded at baseline(1 week before surgery),1 week after surgery,and 1 month after surgery in the three groups.Results: A total of 9 cases were shed and removed from this study: 3 cases in the treatment 1 group,4 cases in the treatment 2 group and 2 cases in the control group.A final total of 111 cases were completed.At baseline(1 week before surgery):there were no significant differences in age,sex and other indexes among the three groups(p>0.05).Postoperative 1 week: in the control group at 1 week postoperative OSDI,FL,lid margin morphology,and lid fat quality increased compared with baseline scores.BUT and SIT decreased,with statistically significant differences(P<0.05).At 1 week postoperative OSDI,BUT treatment group 1 was better than treatment group 2,and treatment group 2 was better than the control group,with statistically significant differences(P<0.05).At 1 week postoperative SIT values between the three groups,the difference was not statistically significant(P>0.05),but the difference change from baseline in treatment group 1 was smaller than that in the control group,and the difference was statistically significant(P<0.05).In terms of FL,lid margin morphology,and lid fat quality,the difference in change from baseline in treatment group 1 compared with treatment group 2 at 1 week after surgery was not statistically significant(P>0.05),and the difference was statistically significant when compared with the control group in all cases(P< 0.05).There was no statistically significant difference between the three groups in the the ability of the meibomian gland to expel secretions(P>0.05).1 month after surgery: SIT and FL in the control group had not yet returned to baseline1 month after surgery,and the difference was statistically significant(P<0.05).The remaining indicators basically returned to baseline level,and the difference was not statistically significant(P>0.05).The difference between the three groups of OSDI was statistically significant(P<0.05).The improvement of OSDI in treatment group 1 and treatment group 2was comparable,and the difference was not statistically significant(P>0.05).Treatment group1 and treatment group 2 were better than the control group,and the differences were statistically significant(P<0.05).The differences between the three groups of BUT were statistically significant(P<0.05),treatment group 1 had better BUT than treatment group 2and the control group,and the differences were statistically significant(P<0.05).The differences between the three groups of SIT,FL,lid margin morphology,the ability of the meibomian gland to expel secretions and lid fat quality,there was no statistically significant difference between the three groups(P>0.05).Conclusion: 1.Pre-operative fumigation of the eye with Huanglian Jiedu decoction and Lid Gland Massage and fumigation of the eye with distilled water and Lid Gland Massage can all improve post-cataract surgery dry eye symptoms,signs and Lid Gland function to some extent and reduce the impact of cataract surgery on the ocular surface.2.Huanglian Jiedu decoction eye fumigation combined with meibomian gland massage was superior to distilled water fumigation combined with meibomian gland massage in enhancing the tolerance of the ocular surface to cataract surgery injury.3.Huanglian Jiedu decoction fumigating the eyes to improve the symptoms of ocular surface after cataract surgery,prolong the tear breakup time relatively significant effect. |
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