这项研究的目的是评估强脉冲光(IPL)治疗在诊断为青光眼和干眼病(DED)的个体中的有效性。
■这项随机对照研究招募了22名诊断为青光眼的个体,年龄从33岁到82岁不等。这些参与者正在接受低血压滴眼液治疗,并具有与干眼相关的临床适应症和主观主诉。每位患者一只眼睛接受三次IPL治疗,而对侧眼作为对照眼(CT)。在三个时间点评估以下参数:基线,第2周和第4周。这些参数包括非侵入性破裂时间(NITBUT),撕裂弯月面高度(TMH),结膜角膜上皮染色评分(CS),泪膜脂质层(TFLL),睑板腺可表达性评分(MGEx),Schirmer我测试,眼眼球红肿评分(OBRS),眼表疾病指数(OSDI)。眼内压(IOP),最佳矫正视力(BCVA),和角膜内皮细胞计数(ECC)进行安全性评估。临床试验于2023年12月25日在ClinicalTrials.gov网站(NCT06158984)注册。
■比较基线和4周测量结果显示,IPL组发现NITBUT显着改善(IPL:8.74±2.60秒。与CT:5.76±1.75秒。p<0.01),TMH(IPL:0.23±0.05mmvs.CT:0.19±0.06mm,p=0.011),C.S.(IPL:1.14±0.56vsCT:1.95±1.17,p=0.005),TFLL(IPL:2.91±2.91vsCT:3.36±0.58,p=0.047),MGEX评分(IPL:1.14±0.35vsCT:1.45±0.51,p=0.020)和OSDI评分(IPL:31.77±15.59vs50.59±21.55,p=0.002)显着改善。相反,其他参数无显著改善(p>0.05).
使用局部抗青光眼药物治疗的个体的眼表疾病的进展可能会恶化。然而,IPL治疗有可能导致干眼的客观和主观测量的显着改善。最佳矫正视力,内皮细胞计数,和眼压被确定在允许的范围内。在研究过程中没有报告不良事件。
结果表明,使用局部药物治疗青光眼的人如果不治疗这个问题,可能会得到更严重的眼表疾病。IPL治疗,另一方面,在客观和主观干眼测试中都会有很大的不同。愿景,内皮细胞计数,IPL治疗后,眼内压力均在正常范围内。即使我们研究中的人患有青光眼,并且已经服用了一年的青光眼药物,而且症状持续很长时间的事实也可能会改变结果。此外,由青光眼药物引起的DED是复杂的,有很多不同的症状和体征,即使在同一阶段。此外,主观投诉可能与临床症状不符。类型,金额,抗青光眼药物的长度可能会影响结果。
UNASSIGNED: The objective of this study was to assess the effectiveness of intense pulsed light (IPL) therapy in individuals diagnosed with glaucoma and dry eye disease (DED).
UNASSIGNED: This randomized control study recruited 22 individuals diagnosed with glaucoma, ranging in age from 33 to 82 years. These participants were undergoing treatment with hypotensive eyedrops and had clinical indications and subjective complaints associated with dry eye. Each patient underwent three sessions of IPL therapy in one eye, while the contralateral eye served as the control eye (CT). The following parameters were assessed at three time points: baseline, week-2, and week-4. These parameters include non-invasive breakup time (NITBUT), tear meniscus height (TMH), conjunctivocorneal epithelial staining score (CS), tear film lipid layer (TFLL), meibomian gland expressibility score (MGEx), Schirmer I test, ocular bulbar redness score (OBRS), and ocular surface disease index (OSDI). Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and corneal endothelial cell count (ECC) were assessed for safety. The clinical trial was registered on 25/12/2023 at ClinicalTrials.gov website (NCT06158984).
UNASSIGNED: Comparing baseline and 4-week measurements revealed that the IPL group found significant improvements in NITBUT (IPL: 8.74±2.60 sec. vs CT: 5.76±1.75 sec. p<0.01), TMH (IPL: 0.23±0.05mm vs CT: 0.19±0.06mm, p=0.011), C.S. (IPL: 1.14±0.56 vs CT: 1.95±1.17, p=0.005), TFLL (IPL: 2.91±2.91 vs CT:3.36±0.58, p=0.047), MGEx score (IPL: 1.14±0.35 vs CT: 1.45±0.51, p=0.020) and OSDI scores (IPL: 31.77±15.59 vs 50.59±21.55, p=0.002) significantly improved. Conversely, other parameters showed no significant improvements (p>0.05).
UNASSIGNED: The progression of ocular surface disease in individuals using topical anti-glaucoma medication may worsen if the condition is not addressed. Nevertheless, IPL therapy has the potential to result in significant improvements in both objective and subjective measures of dry eye. Best-corrected visual acuity, endothelial cell count, and intraocular pressure were determined to be within the permitted limits. No adverse events were reported during the course of the study.
The results show that people who use topical medicines to treat glaucoma may get worse eye surface disease if they do not treat the problem. IPL treatment, on the other hand, can make a big difference in both objective and subjective dry eye tests. The vision, endothelial cell count, and the pressure inside the eye were all found to be within normal limits after the IPL treatment. Even though the people in our study had glaucoma and had been taking glaucoma medicine for it for a year and the fact that the symptoms last for a long time may also change the results. Also, DED caused by glaucoma medication is complicated, with a lot of different symptoms and signs, even in the same stage. Also, subjective complaints may not match up with clinical signs. The type, amount, and length of anti-glaucoma drugs may have affected the results.