Observation on the Efficacy of Optimal Pulse Technology in the Treatment of Meibomian Gland Dysfunction Related Dry Eyes Based on in Vivo Confocal Microscopy Classification

Mingyu CAI; Qian CAO; Junjun LONG; Guojun GAO; Lan LI

doi:10.12259/j.issn.2095-610X.S20230501

Volume 44 Issue 5

May 2023

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Mingyu CAI, Qian CAO, Junjun LONG, Guojun GAO, Lan LI. Observation on the Efficacy of Optimal Pulse Technology in the Treatment of Meibomian Gland Dysfunction Related Dry Eyes Based on in Vivo Confocal Microscopy Classification[J]. Journal of Kunming Medical University, 2023, 44(5): 81-89. doi: 10.12259/j.issn.2095-610X.S20230501

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Observation on the Efficacy of Optimal Pulse Technology in the Treatment of Meibomian Gland Dysfunction Related Dry Eyes Based on in Vivo Confocal Microscopy Classification

doi: 10.12259/j.issn.2095-610X.S20230501

Dept.of Ophtalmology ，Calmette Hospital Affiliated to Kunming Medical University ，Kunming Yunnan 650051，China

Received Date: 2023-01-23
Available Online: 2023-05-12
Publish Date: 2023-05-25

Abstract

Abstract

Objective To classify the meibomian gland dysfunction （MGD） with the use of in vivo confocal microscopy （IVCM）, and to compare optimal pulse technology （OPT） combined with meibomian gland expression （MGX） in the treatment of different types of MGD-related dry eyes. Methods A total of 60 patients （60 eyes） with dry eyes associated with MGD were selected from November 2021 to October 2022 in Outpatient clinic of our hospital.The meibomian glands were examined by IVCM and divided into three types in the stage of increased severity: obstructive type （n = 29）, inflammatory type （n = 18） and fibrotic type （n = 13）. All patients were treated with OPT combined with MGX once every 2 weeks. The ocular surface disease index （OSDI） score, Noninvasive break-up time （NIBUT）, corneal fluorescein staining （CFS）, lipid layer thickness （LLT） and meibomian gland yielding secretion score （MGYSS） were observed and recorded before treatment, 1 month and 3 months after treatment. Results （1） OSDI score: The OSDI score of the three groups decreased 1 month and 3 months after treatment, and the OSDI score of obstructive type and inflammatory type decreased continuously 1 month after treatment compared with 3 months after treatment, the decrease of OSDI score of obstructive type was better than that of inflammatory type 1 months after treatment, and the decrease of OSDI score of obstructive type was better than that of inflammatory type and fibrotic type 3 months after treatment （P < 0.05）; （2） BUT: BUT of the three groups increased 1 month and 3 months after treatment, and the BUT of obstructive type increased continuously 1 month after treatment compared with 3 months after treatment, and the increase of BUT of obstructive type was better than that of inflammatory type and fibrotic type 1 month and 3 months after treatment （P < 0.05）; （3） CFS score:The CFS score of obstructive type decreased 1 month and 3 months after treatment, and the CFS score of inflammatory type and fibrotic type decreased 3 months after treatment, and the difference was statistically significant （P < 0.05）, There was no significant difference among the three types after treatment （P > 0.05）; （4） LLT: The LLT of obstructive type increased 1 month and 3 months after treatment, and the difference was statistically significant （P < 0.05）, There was no significant difference between inflammatory type and fibrotic type before and after treatment （P > 0.05）, There was no significant difference among the three types after treatment （P > 0.05）; （5） MGYSS:MGYSS of the three groups decreased 1 month and 3 months after treatment, and MGYSS decreased continuously in 1 month and 3 months after treatment in the three groups. the decrease of MGYSS in the obstructive type was better than that in the inflammatory type and fibrotic type （P < 0.05）; （6） According to IVCM classification, the stage of increased severity of MGD was positively correlated with the score of loss of meibomian gland （r_s = 0.474, P < 0.001）. Conclusion （1） According to the classification of MGD by ICVM, it can be divided into three types in the stage of increased severity: obstruction type, inflammatory type and fibrotic type. IVCM is a new classification method for MGD, and according to IVCM classification, the stage of increased severity of MGD was positively correlated with the score of loss of meibomian gland; （2） On the basis of IVCM's classification of MGD, Treatment of different types of MGD-related dry eyes with OPT combined with MGX, The effect of obstruction type treatment is better.
- Meibomian gland dysfunction,
- In vivo confocal microscopy,
- Classification,
- Optimal pulse technology,
- Clinical treatment effect

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References(17)

References

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