Clinical Observation Of Preoperative Meibomian Gland Massage In Patients With Cataract Complicated By Meibomian Gland Dysfunction

Objective: To explore the effect of preoperative meibomian gland massage combined with medication on postoperative dry eye symptoms in patients with cataract and meibomian gland dysfunction.Method:A prospective randomized controlled trial was used in this study.All cases were patients with cataract combined with meibomian gland dysfunction in the ophthalmology department of the Fourth Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2019.A total of 69 patients(69 Eyes)were divided into 23 cases of meibomian gland massage group,23 cases of eyelid cleansing group,and 23 cases of control group.The control group was given conventional drug treatment;Eyelid cleansing group: the drug treatment was the same as that of the control group,The eyelid margins were cleaned after a hot compress at 40 °C for 10 minutes in 3 days and 1 day before surgery,and given tobramycin dexamethasone eye ointment;Meibomian gland massage group:The drug treatment is the same as the control group,Massage the meibomian glands after a hot compress at 40 °C for 10 minutes in 3days and 1 day before surgery,and given tobramycin dexamethasone eye ointment.The patient's ocular surface disease index score(OSDI),tear film rupture time(BUT),basal tear secretion test(SIT),corneal fluorescein staining(CFS),and meibomian gland score were recorded at-3d,-1d,1w,1m,3m,and the results were analyzed and analyzed.Results: At 1day before operation,the OSDI score displayed by the meibomian gland massage group was significantly lower than that of the eyelid cleansing group and the control group(P=0.002,P<0.01),and the BUT time was longer(P=0.006,P<0.01)CFS(P=0.017)and meibomian gland score(P=0.049)were lower than those in the control group,but the SIT between the three groups showed no difference(P>0.05);At 1week after the operation,the OSDI(P<0.01,P<0.01)and BUT(P=0.006,P<0.01)displayed in the meibomian gland massage group were lower than those in the eyelid cleansing group and the control group,and the CFS was lower than the control group(P=0.007);there was no significantdifference between the three groups of SIT and meibomian gland score(P>0.05).At 1months after the operation,the OSDI of the meibomian gland massage group was lower than that of the eyelid cleansing group and the control group(P<0.01,P<0.01).BUT in the meibomian gland massage group and the eyelid margin cleaning group were significantly longer than those in the control group(P=0.008,P=0.042).The CFS of meibomian gland massage group was significantly lower than that of the control group(P=0.009).There was no difference between the three groups of SIT and meibomian gland score(P>0.05).At 3 months after the operation,the OSDI of the meibomian gland massage group was significantly lower than that of the eyelid cleansing group and the control group(P=0.035,P<0.01)There were no differences between the three groups of BUT,CFS,SIT and meibomian gland scores(P>0.05).Conclusions: Patients with cataract combined with meibomian gland dysfunction given meibomian gland massage combined with medication before surgery can reduce the dry eye symptoms early after cataract surgery and increase the stability of the tear film.