不同频率强脉冲光治疗睑板腺功能障碍的疗效

Efficacy of different frequency of intense pulsed light in the treatment of meibomian gland dysfunction

摘要:

目的：探讨不同频率强脉冲光(IPL)在睑板腺功能障碍治疗中的有效性和安全性。方法：回顾性研究。选取2021-01/2022-06本院收治的睑板腺功能障碍患者108例216眼，根据患者治疗方案不同分两组，IPL组54例108眼应用能量密度13.0J/cm2，脉宽6ms，延时50ms治疗，先进优化脉冲技术(AOPT)组54例108眼应用能量密度10.0～16.0J/cm2，脉宽7-4-4ms不等分模式治疗。比较两组患者治疗前后眼表症状、角膜荧光素染色评分(FL)、泪膜脂质层厚度(LLT)、眼表疾病指数量表评分(OSDI)、平均非侵入性泪膜破裂时间(NIBUTav)和首次非侵入性泪膜破裂时间(NIBUTf)、泪河高度、睑板腺分泌能力评分及其分泌物性状评分，并统计不良反应发生率。结果：AOPT组患者治疗的有效率(106眼，98.1%)较IPL组高(90眼，83.3%，P<0.05)，治疗后OSDI评分、FL、睑板腺分泌能力评分及其分泌物性状评分、LLT值、NIBUTav、NIBUTf及泪河高度改善效果均优于IPL组(均P<0.001)。但治疗后其不良反应发生率(18眼，16.7%)高于IPL组(4眼，3.7%； P<0.05)。结论：应用AOPT治疗睑板腺功能障碍效果更佳，可明显改善患者的眼表症状和功能，但不良反应较多。应充分结合临床实际情况选择最优治疗方案。

Abstract:

AIM: To investigate the efficacy and safety of frequency of intense pulsed light(IPL)in the treatment of meibomian gland dysfunction.METHODS: In this retrospective study, a total of 108 patients(216 eyes)with meibomian gland dysfunction admitted to our hospital from January 2021 to June 2022 were included. They were divided into two groups, with 54 cases(108 eyes)IPL group(energy density 13.0J/cm2, pulse width 6ms, delay time 50ms), and 54 cases(108 eyes)in advanced optimal pulsed technology(AOPT)group(energy density 10.0-16.0J/cm2, pulse width 7-4-4 ms in unequal-division mode). The clinical effects of the two groups were observed and compared, including ocular surface symptoms, corneal fluorescein staining score(FL), tear film lipid layer thickness(LLT), ocular surface disease index(OSDI)score, mean non-invasive tear film break-up time(NIBUTav)and first non-invasive tear film break-up time(NIBUTf), tear meniscus height, score of meibomian gland secretion and its secretion traits, and the incidence of adverse effects was also calculated.RESULTS: The effective rate of the AOPT group(106 eyes, 98.1%)was higher than that of the IPL group(90 eyes, 83.3%, P<0.05), as well as OSDI score, FL score, score of meibomian gland secretion and its secretion traits, LLT NIBUTav, NIBUTf and tear meniscus height(all P<0.001). However, the incidence of adverse effects of the AOPT group(18 eyes, 16.7%)was higher than that of the IPL group(4 eyes, 3.7%; P<0.05).CONCLUSION: With significant improvement in the ocular surface symptoms and function, AOPT has a better therapeutic effect on the treatment of meibomian gland dysfunction, but it has more adverse reactions. Therefore, optimal treatment plan should be fully selected in combination with the actual clinical situation.