| Purpose This study aimed to evaluate the therapeutic effects of the two therapies named meibomian gland massage combined with drug therapy and meibomian gland massage combined with intense pulsed light(IPL)and drug therapy in dry eye caused by meibomian gland dysfunction(MGD).Methods A prospective randomized clinical trial was studied.There were 60 patients(120 eyes)with dry eye caused by MGD which was collected in department of ophthalmology,Qilu Hospital of Shandong University,from May 2016 to February 2017.And they were divided into two groups.Group A(30 patients,60 eyes)were treated by meibomian gland massage combined with antibiotic eye drops/eye ointment and artificial tear fluid.Group B(30 patients,60 eyes)were treated by meibomian gland massage combined with IPL therapy and antibiotic eye drops/eye ointment as well as artificial tear fluid.The follow-up period was 8 weeks,and reviewed after 2,4,8 week respectively.This test recorded ocular surface disease index(OSDI),slit lamp biomicroscopy examination,meibomian gland scores,Schirmer I test,tear membrane breakup time(BUT),cornea fluorescein staining and slit lamp image before treatment and in 2,4,8 week respectively,evaluated and compared the therapeutic effectiveness of two therapies.To calculate data,K-S test,chi-square test,student t-test and Wilcoxon W test were used.Results There are 60 patients(120 eyes)with MGD dry eye observed in this study.Among them,27 are male patients(54 eyes)and 33 female patients(66 eyes)aged from 18 to 82 years,the average age is(50.18± 13.08)years,duration of 20 days to 10 years,the average course is(2.69±2.46)years.There are no significant differences in gender,age and course of disease between the two groups(P>0.05),as well as between male and female patients in the same group.Before treatment,average Schirmer I test is(2.37±1.74)mm,BUT is(3.69±1.35)s,OSDI is(68.33±29.23),meibomian gland score is(4.57±1.13),and 1 patient has corneal fluorescein staining(+)in group A(1.67%);average Schirmer I test is(2.55±1.64)mm,BUT is(3.61±1.22)s,OSDI is(80.00±16.75),meibomian gland score is(4.93±1.01)and 1 patient has corneal fluorescein staining(+)in group B(1.67%).There was no significant difference between the two groups(P>0.05).At 2-weeks follow-up,average Schirmer I test is(2.98±2.14)mm,BUT is(3.91 ± 1.33)s,OSDI is(66.38±28.99)in group A,and there is no significant difference compared with the data before treatment(P>0.05);average BUT(4.78±1.71)s is significantly increased than that before treatment(P<0.05),OSDI(53.61±18.91)is significantly decreased than that before treatment(P<0.05),Schirmer I test(3.02±1.83)mm,There was no significant difference compared with before treatment(P = 0.055).At 4 weeks follow-up,the Schirmer I test is(3.13±1.90)mm,BUT is(5.38±1.54)s,OSDI is(39.44±19.57),there is a significant difference in BUT and OSDI(P<0.05),no significant difference in Schirmer I test(P= 0.624)in group A;Schirmer I test(5.53±2.00)mm,BUT(6.86±1.74)s,OSDI(28.61±15.11)in group B,which has significant difference compared with the data before treatment and 2-weeks(P<0.05),and the treatment effect of group B is better than that of group A(P<0.05).At 8-weeks follow-up,average Schirmer I test(7.15±2.17)mm,BUT(7.84±1.88)s,OSDI(16.39±13.92),meibomian gland score(1.43±1.07)in group A have significant difference with former data(P<0.05);average Schirmer I test(7.95±2.09)mm,BUT(8.43±1.99)s,OSDI(14.17±12.01),meibomian gland score(1.23±0.90)in group B have significant difference with former data(P<0.05).There is no significant difference in BUT,OSDI,meibomian gland score between group B and group A(P = 0.103,0.707,0.488).During the whole therapeutic process,there is no significant difference between male and female patients in the same group(P>0.05).Conclusion Both meibomian gland massage combined with drug and meibomian gland massage combined with IPL and drug therapy can improve symptoms,signs and tear function of dry eye caused by MGD.Compared with the traditional therapy,the meibomian gland massage combined with IPL and drug has faster effect.BUT and OSDI have important effect on diagnosis.Gender difference can influence morbidity of this disease,but has no effect on therapeutic effect.When the course of treatment reaches 8 weeks,the two methods can achieve the same effect. |
PDF Full Text Request