Risk Assessment Of MGD And Comparison Of Efficacy Of IPL In Treating MGD In Western Yunnan

Purpose To explore the main risk factors of meibomian gland dysfunction(MGD)in western Yunnan,and to evaluate the efficacy of meibomian gland massage,IPL treatment combined with artificial tears for MGD type dry eye patients.Methods The first part of this study is a cross-sectional research method;The second part is a randomized,double-blind,controlled trial.The first part includes patients diagnosed with dry eyes at the ophthalmology outpatient department of the First Affiliated Hospital of Dali University from January to November 2022 as the inclusion subjects.Conduct a survey on the current situation of MGD using a self-made questionnaire and collect potential risk factors for MGD.And analyze the main risk factors for MGD in the western Yunnan region through a multi factor logistic regression model.The second part includes40 MGD patients;The patients were divided into group A and group B by random number table.20 patients(40 eyes)in group A were treated with meibomian gland massage and artificial tears;In group B,20 people(40 eyes)were treated with intense pulsed light(IPL)combined with artificial tears.And before treatment and 1 week and 4 weeks after treatment,two groups of patients were analyzed with an eye surface analyzer to collect the height of the lacrimal canal,non-invasive tear film rupture time(BUT),and conjunctival congestion index;Collect experimental data such as tear secretion test(Schirmer I test)and corneal fluorescence staining(CFS),record each data,and retain slit lamp images.To evaluate the efficacy comparison of two treatment regimens for MGD.The data was analyzed using statistical methods such as chi square test,independent sample t-test,and paired sample t-test.Results Part 1:A total of 466 survey questionnaires were included.Among them,198male patients accounted for 42.5%,and 268 female patients accounted for 57.5%.Univariate analysis:There was a significant age difference between the MGD and non MGD groups,with the MGD group being older than the non MGD group(X~2=17.857,P<0.001).Compared to the non MGD group,there was a statistically significant difference(P<0.05)in factors such as Sjogren’s syndrome,involvement in video terminal work,prolonged use of electronic screens,prolonged outdoor work,prolonged exposure to air-conditioned rooms,prolonged exposure to pathological buildings,working at high altitudes,staying up late,smoking,and drinking in the MGD group.Multivariate logistic regression analysis:Suffering from Sjogren’s syndrome(OR=9.77,P=0),connective tissue disease(OR=2.12,P=0.021),and working in high-altitude areas(OR=2.1,P=0.002)are the main risk factors for MGD.Part 2:40 patients(80 eyes)were included,including13 male patients(26 eyes)and 27 female patients(54 eyes),with an average age of 35.3±11.3 years(between 19-60 years old).During the study period,there were no adverse events such as corneal burns,eyelid burns,and anterior segment inflammation.A.There was no significant difference in gender,age,and pre treatment data of the Eye Surface Disease Index(OSDI)between Group B before Schirmer I trial treatment.A.The OSDI scores of both groups B improved after treatment;BUT improved significantly in groups A and B after 1 month of treatment,with statistical significance(P<0.05),but only the IPL treatment group showed statistical significance in BUT after 2 months of treatment(P<0.05).There was no difference in the red eye indicators between the two groups after treatment(P>0.05);Corneal fluorescence staining showed no significant changes after treatment in the meibomian gland massage group(P>0.05),while there was a significant difference in the IPL treatment group(P<0.05).The height of the tear river showed statistical significance in both groups after treatment for 1 month(P<0.05).However,after 2 months of treatment,the difference between the IPL group and the meibomian gland massage group was significant;Schirmer I showed statistical significance after treatment in both groups(P<0.05).Tear inflammatory factors only showed significant differences in IL-6(P=0.010)and IL-8(P=0.012)after IPL treatment,while there was no difference in the meibomian gland group.Conclusion Part I:The prevalence of MGD in western Yunnan is relatively high,and there are many influencing factors that lead to its occurrence.The main risk factors are Sjogren’s syndrome,connective tissue disease,and working in high-altitude areas.Part II:Meibomian gland massage combined with artificial tears and IPL combined with artificial tears can improve the symptoms and signs of MGD,both of which are effective for MGD.Clinical treatment can be selected according to the patient’s condition and needs.IPL treatment can reduce inflammatory factors such as IL-6 and IL-8 in patients’tears.Compared to meibomian gland massage combined with medication treatment,IPL treatment has a longer duration of efficacy.Gender has no effect on the combination of meibomian gland massage and medication therapy,as well as IPL and medication therapy.