摘要
目的:探讨0.5%氯替泼诺混悬滴眼液联合睑板腺探通术对重度阻塞型睑板腺功能障碍的疗效观察。方法:收集2024年10月至2025年2月期间就诊于我院眼科门诊且诊断为重度阻塞型睑板腺功能障碍患者共42例(84眼),随机将患者分为治疗组和对照组,各21例共42眼。两组患者均予以常规治疗(玻璃酸钠滴眼液0.1 g•kg^(-1),3次•d^(-1)+睑板腺按摩1次•w^(-1),持续4 w),治疗组在此基础上予以0.5%氯替泼诺混悬滴眼液0.1g•kg^(-1),滴眼2次•d^(-1),联合睑板腺探通术1次•w^(-1),持续4 w,治疗前后分别在裂隙灯下对两组患者眼表疾病指数评分、睑缘评分、睑板腺体缺失评分、睑板腺睑酯排出能力评分、睑板腺睑酯性状评分,荧光素染色泪膜破裂时间测定。结果:治疗4 w后,两组患者上述指标除泪膜破裂时间外均低于治疗前(P<0.05)泪膜破裂时间高于治疗前(P<0.05),治疗组各项临床指标均优于对照组。结论:氯替泼诺联合探通可促进睑酯排出,减轻炎症,改善重度阻塞型睑板腺功能障碍患者眼部不适症状,提高生活质量。
Objective:To explore the efficacy of 0.5%clomethasone suspension eye drops combined with meibomian gland probing in the treatment of severe obstructive meibomian gland dysfunction.Methods:A total of 42 patients(84 eyes)diagnosed with severe obstructive meibomian gland dysfunction who visited our ophthalmology outpatient department from October 2024 to February 2025 were enrolled.The patients were randomly divided into a treatment group and a control group,with 21 cases(42 eyes)in each group.Both groups received conventional treatment(0.1 g•kg^(-1) sodium hyaluronate eye drops,3 times/day+meibomian gland massage once per week for 4 weeks).The treatment group received an additional 0.5%clomethasone suspension eye drops at 0.1 g•kg^(-1),twice daily,combined with meibomian gland probing once per week for 4 weeks.Before and after treatment,the ocular surface disease index score,eyelid margin score,meibomian gland loss score,meibomian gland lipid excretion ability score,meibomian gland lipid character score,and breakup time of the fluorescein-stained tear film were measured under slit lamp examination in both groups.Results:After 4 weeks of treatment,all the aforementioned indicators except for the breakup time of the tear film were significantly lower in both groups than before treatment(P<0.05),while the breakup time of the tear film was significantly higher(P<0.05).The clinical indicators in the treatment group were superior to those in the control group.Conclusion:The combination of clomethasone and probing can promote meibomian lipid excretion,reduce inflammation,improve ocular discomfort symptoms in patients with severe obstructive meibomian gland dysfunction,and enhance their quality of life.
作者
杨家海
王方
Yang Jia-hai;Wang Fang(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;Department of Ophthalmology,The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China)
基金
国家自然科学基金项目(编号:81660809)。
关键词
氯替泼诺混悬滴眼液
睑板腺功能障碍
睑板腺探通术
Lotephardol suspension eye drops
Meibomian gland dysfunction
Meibomian gland probing
