Successful tear lipid layer treatment for refractory dry eye in office workers by low-dose lipid application on the full-length eyelid margin
Successful tear lipid layer treatment for refractory dry eye in office workers by low-dose lipid application on the full-length eyelid margin
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DOI：
10.1016/j.ajo.2006.03.022
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发表时间：
2006-08-01
影响因子：
4.2
通讯作者：
Tsubota, Kazuo
中科院分区：
文献类型：
--
作者：
Goto, Eiki;Dogru, Murat;Tsubota, Kazuo
目的：探讨小剂量脂类敷贴于眼睑全长边缘治疗常规治疗效果不佳的干眼症。设计：前瞻性干预性病例系列。方法：选择30例(30只眼)干眼症患者，均为常规治疗无效的干眼症患者。为了使用具有极性和非极性脂基的商业上可获得的非保藏局部药物来供应脂质，选择了氧氟沙星眼膏(日本大阪三天药业)。小剂量氧氟沙星软膏涂抹于全长眼睑边缘，每天三次，持续两周。结果：治疗后眼干症状评分由治疗前的91.4+/-11.9降至33.6+/-21.0(P<；0.0001)，眼干症状评分由治疗前的39+/-4 nm升至161+/-91 nm(P<；0.0001)。由2.6+/-1.6秒延长至4.8+/-2.1秒(P=0.01)，表现力分级由2.8+/-1.3降至1.6+/-1.3(P=.0005)。结论：对于难治性干眼症，用小剂量泪脂层软膏涂抹于全长眼睑边缘是一种有效的治疗方法。涂抹的脂类形成了均匀的脂层，有助于泪液的稳定，导致症状的改善。
PURPOSE: To test tear lipid layer treatment by low-dose lipid application on the full,length eyelid margin for the treatment of office workers with dry eyes refractory to conventional treatments.DESIGN: Prospective interventional case series.METHODS: Thirty eyes of 30 office workers with dry eyes with dark tear interference images, which did not respond to conventional treatments, were included. To supply lipid using a commercially available nonpreserved topical medication having both polar and nonpolar lipid base, ofloxacin eye ointment (Santen Pharmaceutical Osaka, Japan) was selected. Low-dose ofloxacin ointment application on the full-length eyelid margin was carried out three times a day for two weeks. The symptom of ocular dryness using a visual analog scale, tear interferometry to assess lipid layer thickness (LLT), corneal fluorescein staining, tear-film breakup time (BUT), and meibum expressibility gradings were compared.RESULTS: After the treatment, the symptom score of ocular dryness decreased from 91.4 +/- 11.9 to 33.6 +/- 21.0 (P < .0001), LLT increased from 39 +/- 4 nm to 161 +/- 91 nm (P < .0001), BUT was prolonged from 2.6 +/- 1.6 seconds to 4.8 +/- 2.1 seconds (P =.01), and meibum expressibility gradings decreased from 2.8 +/- 1.3 to 1.6 +/- 1.3 (P =.0005).CONCLUSION: For office workers with refractory dry eyes, tear lipid layer treatment by low-dose ointment applied on the full,length eyelid margin was shown to be an effective approach. The applied lipid formed a uniform lipid layer, which contributed to tear stability, leading to the improvement of the symptom.