山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (3): 91-95.doi: 10.6040/j.issn.1673-3770.0.2017.495

• ·论著· • 上一篇    下一篇

热脉动系统对轻、中度睑板腺功能障碍治疗的临床观察

李上1,张薇1,卢红双2,臧云晓2,董宏伟1,郭纯刚1,潘志强2,接英2   

  1. 1.首都医科大学附属北京佑安医院眼科, 北京 100069;
    2.北京同仁眼科中心 首都医科大学附属北京同仁医院, 北京 100730
  • 收稿日期:2017-11-26 出版日期:2018-05-20 发布日期:2018-05-20
  • 通讯作者: 接英. E-mail:jie_yingcn@aliyun.com
  • 基金资助:
    国家自然科学基金(81170824);北京市自然科学基金(7182037);卫生系统高层次卫生技术人才培养计划(2013-3-055)

Clinical observations following thermal pulsation system treatment for mild and moderate meibomian gland dysfunction

LI Shang1, ZHANG Wei1, LU Hongshuang2, ZANG Yunxiao2, DONG Hongwei1, GUO Chungang1, PAN Zhiqiang2, JIE Ying2   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2017-11-26 Online:2018-05-20 Published:2018-05-20

摘要: 目的 评价热脉动系统LipiFlow对轻、中度睑板腺功能障碍(MGD)的患者治疗并随访6个月的临床效果。 方法 回顾性分析2016年3月至2016年11月在北京佑安医院眼科就诊,并进行LipiFlow治疗的15例(30眼)睑板腺功能障碍患者的临床资料。受试者分别在治疗前,治疗后3个月,治疗后6个月进行SPEED问卷,不完全眨眼比率(PB),脂质层厚度(LLT),泪膜破裂时间(TBUT),基础泪液分泌量(SIt)和睑板腺开口油脂分泌情况(MGYLS)。 结果 SPEED问卷评分在治疗后3个月和6个月时分别为10.20±3.57和9.87±3.68,与治疗前的12.13±2.42相比降低。PB比率在治疗后3个月和6个月时分别为60%和62.45%,与治疗前的72.24%相比下降。LLT在治疗前、治疗后3个月和治疗后6个月分别为(71.70±21.23)nm,(72.03±20.52)nm和(74.60±20.07)nm。TBUT在治疗前、治疗后3个月和治疗后6个月分别为(5.37±2.19)s,(6.33±2.34)s和(6.40±2.50)s。 SIt在治疗前、治疗后3个月和治疗后6个月分别为(5.30±4.41)mm,(5.93±4.51)mm和(7.43±7.26)mm。MGYLS在治疗前、治疗后3个月和治疗后6个月分别为3.50±2.11,4.23±1.99和3.83±1.97。LLT,TBUT,SIt和MGYLS三个时间点进行两两比较,无统计学差异。 结论 热脉动系统可以减轻轻、中度睑板腺功能障碍的主观症状,同时改善不完全眨眼的比率,可以巩固治疗效果长达6个月。

关键词: 热脉动系统, LipiFlow, 睑板腺功能障碍

Abstract: Objective To assess the clinical outcomes of using Lipiflow thermal pulsation system, on mild to moderate meibomian gland dysfunction(MGD), during treatment and at the 3 and 6 months follow up visit. Methods A retrospective analysis of clinical data of MGD patients who sought medical help and underwent LipiFlow treatment at Beijing Youan Hospital from March to November 2016, was conducted. The participants answered a SPEED questionnaire for before, and 3 and 6 months after treatment. In addition, other indicators assessed included, partial blinks(PB), lipid layer thickness(LLT), tear break-up time(TBUT), Schirmer I test(SIT), and meibomian glands yielding liquid secretion(MGYLS). Results SPEED scores at 3 and 6 months, after treatment, were(10.20±3.57)and(9.87±3.68)respectively, significantly lower than(12.13±2.42)before treatment. PB rate assessed at the same time points after treatment was 60% and 62.4%, significantly different than 72.24% before treatment. The other scores, in the order before treatment, 3 and 6 months after treatment, were as follows: LLT scores were(71.70±21.23),(72.03±20.52), and(74.60±20.07)nm; TBUT scores were(5.37±2.19),(6.33±2.34), and(6.40±2.50)s; SIT scores were(5.30±4.41),(5.93±4.51), and(7.43±7.26)mm; and MGYLS scores were(3.50±2.11),(4.23±1.99), and(3.83±1.97). No statistically significant differences were found for LLT, TBUT, SIT, and MGYLS scores. Conclusion Subjective symptoms were improved by thermal pulsation system treatment in mild and moderate MGDs, and PB rates were lowered. The efficacy lasted for up to 6 months.

Key words: Meibomian gland dysfunction, LipiFlow, Thermal pulsation system

中图分类号: 

  • R777
[1] Nichols KK. The international workshop on meibomian gland dysfunction: introduction[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1917-1921.
[2] Lemp MA, Crews LA, Bron AJ, et al. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study[J]. Cornea, 2012, 31(5):472-478.
[3] Schaumberg DA, Nichols JJ, Papas EB, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on the epidemiology of, and associated risk factors for, MGD[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1994-2005.
[4] Olson MC, Korb DR, Greiner JV. Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction[J]. Eye Contact Lens, 2003, 29(2):96-99.
[5] Qiao J, Yan X. Emerging treatment options for meibomian gland dysfunction[J]. Clin Ophthalmol, 2013, 7:1797-1803. DOI: 10.2147/OPTH.S33182.
[6] Greiner JV. A single LipiFlow(R)Thermal Pulsation System treatment improves meibomian gland function and reduces dry eye symptoms for 9 months[J]. Curr Eye Res, 2012, 37(4):272-278.
[7] Zhao Y, Xie J, Li J, et al. Evaluation of monocular treatment for meibomian gland dysfunction with an automated thermodynamic system in elderly chinese patients: a contralateral eye study[J]. J Ophthalmol, 2016:9640643. DOI: 10.1155/2016/9640643.
[8] Lane SS, Dubiner HB, Epstein RJ, et al. A new system, the LipiFlow, for the treatment of meibomian gland dysfunction[J]. Cornea, 2012, 31(4):396-404.
[9] Finis D, Pischel N, Konig C, et al. Comparison of the OSDI and SPEED questionnaires for the evaluation of dry eye disease in clinical routine [J]. Ophthalmology, 2014, 111(11):1050-1056.
[10] Finis D, Pischel N, Schrader S, et al. Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for meibomian gland dysfunction[J]. Cornea, 2013, 32(12):1549-1553.
[11] 梁庆丰,刘含若,郭燕,等. 睑板腺热脉动系统治疗睑板腺功能障碍的临床观察[J]. 中华眼科杂志, 2015, 51(12):924-931. LIANG Qingfeng, LIU Hanruo, GUO Yan, et al. Clinical evaluation of a thermodynamic treatment system for meibomian gland dysfunction[J]. Chin J Ophthalmol, 2015, 51(12):924-931.
[12] Korb DR, Blackie CA. Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location[J]. Cornea, 2008, 27(10):1142-1147.
[13] 梁庆丰,高超,梁虹,等. 活体共聚焦显微镜对睑板腺功能障碍患者睑板腺形态检测的应用研究[J]. 中华眼科杂志, 2016, 52(9):649-656. LIANG Qingfeng, GAO Chao, LIANG Hong, et al. In vivo confocal microscopy evaluation of meibomian glands in meibomian gland dysfunction patients[J]. Chin J Ophthalmol, 2016, 52(9):649-656.
[14] Bron AJ, Tiffany JM. The contribution of meibomian disease to dry eye[J]. Ocul Surf, 2004, 2(2):149-165.
[15] Butovich IA, Lu H, Mcmahon A, et al. Biophysical and morphological evaluation of human normal and dry eye meibum using hot stage polarized light microscopy[J]. Invest Ophthalmol Vis Sci, 2014, 55(1):87-101.
[16] Despa F, Orgill DP, Neuwalder J, et al. The relative thermal stability of tissue macromolecules and cellular structure in burn injury[J]. Burns, 2005, 31(5):568-577.
[17] Korb DR, Blackie CA. Restoration of meibomian gland functionality with novel thermodynamic treatment device-a case report[J]. Cornea, 2010, 29(8):930-933.
[18] Finis D, Hayajneh J, Konig C, et al. Evaluation of an automated thermodynamic treatment(LipiFlow(R))system for meibomian gland dysfunction: a prospective, randomized, observer-masked trial[J]. Ocul Surf, 2014, 12(2):146-154.
[19] Nichols KK, Nichols JJ, Mitchell GL. The lack of association between signs and symptoms in patients with dry eye disease[J]. Cornea, 2004, 23(8):762-770.
[20] Greiner JV. Long-term(12-month)improvement in meibomian gland function and reduced dry eye symptoms with a single thermal pulsation treatment[J]. Clin Exp Ophthalmol, 2013, 41(6):524-530.
[21] Zhao Y, Veerappan A, Yeo S, et al. Clinical trial of thermal pulsation(lipiflow)in meibomian gland dysfunction with preteatment meibography[J]. Eye Contact Lens, 2016, 42(6):339-346.
[22] Finis D, Konig C, Hayajneh J, et al. Six-month effects of a thermodynamic treatment for MGD and implications of meibomian gland atrophy[J]. Cornea, 2014, 33(12):1265-1270.
[23] Greiner JV. Long-Term(3 Year)Effects of a single thermal pulsation system treatment on meibomian gland function and dry eye symptoms[J]. Eye Contact Lens, 2016, 42(2):99-107.
[24] Blackie CA, Solomon JD, Scaffidi RC, et al. The relationship between dry eye symptoms and lipid layer thickness[J]. Cornea, 2009, 28(7):789-794.
[25] Kojima T, Ibrahim OM, Wakamatsu T, et al. The impact of contact lens wear and visual display terminal work on ocular surface and tear functions in office workers[J]. Am J Ophthalmol, 2011, 152(6):933-940.
[26] 孟珠,宋建军,杨柳,等. Lipiview(R)眼表面干涉仪辅助的中老年人干眼症状与体征的相关性研究[J]. 眼科新进展, 2017, 37(2):143-146. MENG Zhu, SONG Jianjun, YANG Liu, et al. Study on correlation of dry eye symptoms and signs in middle-aged and aged people by Lipiview(R)ocular surface interferometry[J]. Rec Adv Ophthalmol, 2017, 37(2):143-146.
[27] Ousler GR, Abelson MB, Johnston PR, et al. Blink patterns and lid-contact times in dry-eye and normal subjects[J]. Clin Ophthalmol, 2014, 8:869-874. DOI: 10.2147/OPTH.S56783.
[28] Elliott JC, Baird B, Giesbrecht B. Consciousness isn't all-or-none: Evidence for partial awareness during the attentional blink[J]. Conscious Cogn, 2016, 40:79-85.
[1] 刘钊, 吴昌睿, 高宁. 白内障超声乳化摘除手术对睑板腺功能的影响[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 68-70.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!