| Objective：To modify the manipulation method of meibomian compression in the treatment ofmeibomian gland dysfunction (MGD) and to compare the difference of the improved method andconventional method in the therapeutic effect, operative feasibility and ocular surface damage inMGD treatment.Method：Forty cases of MGD patients were randomly divided into2groups,20patients whowere chosed as the innovatived group were treated by improved meibomian gland compression,the other20patients were sorted as conventional group and treated with traditional meibomiangland compression. The personal information and past medical history were recorded,ophthalmological check up list including Fluorescein stain test (FL), Fluorescein tear break-uptime (BUT), Schirmer I Test (SIT). Tarsal conjunctival impression cytology was applied to studythe cytological changes after both method of meibomian compression. Ocular Surface DiseaseIndex (OSDI)、meibomian score were recorded to evaluate the severity of the MGD．Result：Tthe frequency of complaint from high to low is eyestrain，dryness of eye，sensitive tolight，blur vision，painful or sore feeling，foreign body feeling，heaviness in the upper eyelid，redness，tearing，eye itching，increased discharges，burning sensation and inexplicable discomfort.BUT, FL, SIT, meibomian gland scores and OSDI sores was no difference before treatment intwo groups（P>0.05）, these objective parameters were significantly improved after treatment intwo group（P＜0.05）. The duration of treatment in conventional group was15±3.5minuteswhich is significantly longer than2.5±1.5minutes in innovatived group (t=32.50, P <0.01).Tarsal conjunctiva impression cytology showed that epithelial cells in the innovatived groupwere mostly intact while in conventional group, the morphological changes was great, a largeamount of cells were necrosis and lost the contour (continuity corrected Chi-square=23.907, P= 0.000). After education,17patients in the innovatived group can handle meibomain compressionby themselves at home. Within the follow-up time, no patients in the innovatived group had anyside effect while three cases in the conventional group presented conjunctival hyperemia,increased discharge and acute conjunctival inflammation in the next day, symptoms disappearafter application of antibiotic eye drops.Conclusion: The modified and traditional method of meibomain gland compression can greatlyrelieve eye discomfort caused by MGD. Improved meibomian gland compression method issuperior to conventional method in the manipulation time, feasibility and the degree of tarsalconjunctival epithelial damage. It is worth popularized and can serve as a domestic physicaltherapy for MGD.Part2. Analysis of Meibum by GC-MSObjective：To analyze and identify the meibum by GC-MS. Method：The meibum from twohealthy person and six MGD patients were separated and analyzed by gas chromatography-massspectrometer (GC-MS). GC conditions: Column: DB-5MS (30m×0.25mm×0.25μm) capillarycolumn, carrier gas: He, flow rate:1.0ml/min; injection amount:1ml. MS conditions: MSionization mode: EI; electron impact source electron energy:70eV, ion source temperature:200℃; electron multiplier voltage of1.10KV; solvent delay time:1.00min; scanning mode: San;scanning range m/z20-500aum. The component of meibum was identified by El massfragmentation and the standard substance in the database. The relative content of the componentswas calculated by the method of chromatographic peak area normalization.Result：In the8samples that were analyzed by GC-MS,102chromatography peaks wereseparated. The component and kinds in these samples differ greatly. Seventeen compounds wereidentified which included six kinds of alkanes, two kinds of olefins, three kinds of alcohols, onekind of enal and esters, three kinds of fatty acids and one kind of amides. The amount of these17component that has been identificated occupied73.2％、23.5％、41.1％、49.5％、85.4％、75.5％、23.5％、55.3％、24.5％in the eight samples respectively. The amount of squalene, palmiticacid, stearic acid and other ingredients differs greatly in different samples.Conclusion: The sorts of meibum are versatile. The contents differ greatly in different samplesthe changes in meibum might relate to MGD. |
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