睑板腺疏通对白内障患者术后干眼症状和睑板腺功能的影响

蔡佳馨; 刘美芳; 谢晶; 刘玺

doi:10.16016/j.2097-0927.202305049

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睑板腺疏通对白内障患者术后干眼症状和睑板腺功能的影响

临床医学 | 更新时间：2026-01-09

- 睑板腺疏通对白内障患者术后干眼症状和睑板腺功能的影响
- Effects of clearing blockage of meibomian gland ducts prior to cataract surgery on dry eye and gland function
- 陆军军医大学学报 2024年46卷第3期页码：288-293
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院眼科
- 作者简介：
  
  [ 刘玺，E-mail：17950394@qq.com LIU Xi, E-mail: 17950394@qq.com
- 基金信息：
  
  陆军军医大学校管课题青年培育项目(2019XQN09);国家自然科学基金青年科学基金(82000921)
- DOI：10.16016/j.2097-0927.202305049
  中图分类号： R776.1;R777.13;R777.34
- 收稿：2023-05-16，
  
  修回：2023-08-15，
  
  纸质出版：2024-02-15
- 稿件说明：
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蔡佳馨, 刘美芳, 谢晶, 等. 睑板腺疏通对白内障患者术后干眼症状和睑板腺功能的影响[J]. 陆军军医大学学报, 2024,46(3):288-293.

Jiaxin CAI, Meifang LIU, Jing XIE, et al. Effects of clearing blockage of meibomian gland ducts prior to cataract surgery on dry eye and gland function[J]. Journal of Army Medical University, 2024, 46(3): 288-293.
蔡佳馨, 刘美芳, 谢晶, 等. 睑板腺疏通对白内障患者术后干眼症状和睑板腺功能的影响[J]. 陆军军医大学学报, 2024,46(3):288-293. DOI： 10.16016/j.2097-0927.202305049.

Jiaxin CAI, Meifang LIU, Jing XIE, et al. Effects of clearing blockage of meibomian gland ducts prior to cataract surgery on dry eye and gland function[J]. Journal of Army Medical University, 2024, 46(3): 288-293. DOI： 10.16016/j.2097-0927.202305049.

摘要

目的

探讨白内障术前睑板腺疏通治疗对术后手术相关性睑板腺功能障碍及干眼的疗效。

方法

本研究为前瞻性随机对照研究。纳入2021年6-12月在我科行白内障手术的110例老年性白内障患者。采用随机数字表法分为睑板腺疏通治疗组(

=56)和对照组(

=54)，睑板腺疏通治疗组在白内障手术前1周接受睑板腺疏通治疗1次，对照组不作任何处理。睑板腺疏通治疗前、术后1个月及3个月比较两组的眼表疾病指数(ocular surface disease index

OSDI)评分、睑板腺功能(油脂厚度LLT、睑板腺开口数量MYGLS、睑板腺分泌物评分MGYSS)、泪膜破裂时间(tear film break-up time

TBUT)。

结果

对照组在白内障手术后1个月表现出MGYLS显著下降(

＜0.05)，MGYSS显著升高(

＜0.01)，LLT显著降低(

＜0.01)，TBUT降低，干眼症状显著增加，其中OSDI评分显著升高(

＜0.05)。相反，睑板腺疏通组MGYLS显著提高(

＜0.01)，MGYSS显著降低(

＜0.01)，LLT升高，TBUT增加，OSDI评分主观结果得到改善。

结论

白内障手术前进行睑板腺疏通治疗可能是一种安全有效的干预措施，可缓解手术引起的睑板腺功能障碍和干眼症。

Abstract

Objective

To investigate the effects of clearing meibomian gland ducts prior to cataract surgery on the gland dysfunction and dry eye induced by surgery.

Methods

A prospective

randomized controlled trial was conducted on 110 patients (110 eyes) undergoing elective cataract surgery for senile cataract in our department from June 1

to December 31

2021. The participants were randomly allocated into treatment (

=56) and control (

=54) groups. The patients from the treatment group were given eye

lid compresses and cleaning to remove an obstructed meibum in 1 week prior to cataract surgery

while those from the control group received no such treatment. Ocular surface disease index (OSDI)

indicators related to meibomian gland function

including tear film lipid layer thickness (LLT)

meibomian glands yielding liquid secretion (MGYLS)

meibomian glands yielding secretion score (MGYSS)

and tear film break-up time (TBUT) before

and 1 and 3 months after surgery were employed to evaluate the efficacy of clearing meibomian gland ducts.

Results

The control group exhibited significantly decreased MGYLS (

0.05)

increased MGYSS (

0.01)

thinner LLT (

0.01)

shorter TBUT

worsened dry eye symptoms

and elevated OSDI score (

0.05) in 1 month after surgery. Conversely

the treatment group showed significantly improved MGYLS (

0.01)

decreased MGYSS (

0.01)

thicker LLT

extended TBUT

and improved subjective outcomes reported on OSDI.

Conclusion

Our preoperative meibomian gland treatment prior to cataract surgery may be a safe and effective intervention for relieving dry eye and meibomian gland dysfunction induced by surgery.

关键词

Keywords

references

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