Clinical Study Of Patients With Meibomian Gland Dysfunction Combined With Demodex Infection

Objective:To investigate the treatment and effect of chronic MGD combined with Demodex infection by comparing the ocular conditions of patients before and after treatment with three different methods(physiotherapy,tea tree oil eye patch,and tea tree oil eye patch combined with physiotherapy),and to provide theoretical reference and basis for clinical treatment of MGD combined with Demodex infection.Methods:1.A total of 208 patients(416 eyes)diagnosed with MGD and proposed for conventional physiotherapy at the First People’s Hospital of Changde Ophthalmology Clinic from June 2021 to December 2021 were selected for peristomal mite examination to observe the peristomal mite infection in MGD patients.2.The treatment data of 135 patients(270 eyes)diagnosed with MGD and positive for crepuscular mites in the outpatient clinic of Changde First People’s Hospital from June 2021 to December 2021 were retrospectively analyzed and divided into three groups according to different treatment methods: group A(42 cases;84 eyes): treatment with hot massage of the lid gland;group B(46 cases;92 eyes): application of tea tree oil eye patch to remove mites,group C(47 cases;94 eyes).Group C(47 cases;94eyes): comprehensive treatment: tea tree oil eye patch combined with lid gland hot compress massage;patients in the three groups were treated with0.1% flumetron eye drops and sodium vitreous acid eye drops at the same time,and the treatment period was 1 month.The subjective symptom score(OSDI),non-invasive tear break-up time(NIBUT),number of demodex,lid gland score and tear meniscus height were compared before and after treatment in the three groups,and the treatment effects were analyzed.Results:(1)The Demodex eyelash were positive for162(78.1%).(2)There were no significant differences in gender,age,subjective symptom score(OSDI),non-invasive break-up time(NIBUT),number of Demodex,lid gland score,and tear meniscus height in the 3 groups compared with each other before treatment(P > 0.05),which were comparable.(3)After treatment,the non-invasive break-up time(NIBUT)was significantly prolonged in the 3 groups compared with that before treatment,and the prolongation was more significant in group C than in groups A and B.The number of demodex was significantly reduced in the 3 groups compared with that before treatment,and the reduction was more significant in group B than in group A,and in group C than in group B.The difference was statistically significant(P < 0.05);The subjective symptom scores(OSDI)and lacrimal gland scores were significantly reduced in the 3 groups compared with that before treatment,and the reduction was more significant in group C than in groups A and B.The difference was statistically significant(P < 0.05);the tear meniscus height of patients in the 3 groups was higher than that before treatment,The difference was statistically significant(P<0.05),but the difference was not statistically significant when comparing the 3 groups.(P>0.05)Conclusion:1.Patients with blepharosphenoid dysfunction have a higher rate of Demodex infection,and patients with MGD should pay attention to crepuscular mite screening2.Tea tree oil eye patch combined with physical heat cleaning treatment was better than physical therapy alone and tea tree oil eye patch alone.Physical therapy enhanced the anti-mite and anti-inflammatory effects of tea tree oil,more effectively reduced the number of crepuscular mites,reduced lid gland damage,restored lacrimal gland stability,and better treated MGD.