| Objective:Analyze the safety and effectiveness of applying intense pulsed light(IPL)in the treatment of moderate to severe visual display terminal(VDT)related dry eyes.Method:Fifty patients(100 eyes)diagnosed with moderate to severe VDT related dry eyes at the Dry Eye Clinic of the Second Affiliated Hospital of Nanchang University from June 2022 to December 2022 were enrolled as the subjects.According to the voluntary principle of patients,the patients were non-randomly divided into two treatment groups: A and B.25 patients(50 eyes)in Group A were treated with meibomian gland massage combined with medication.25 patients(50 eyes)in Group B were treated with IPL combined with meibomian gland massage and medication.Intergroup comparisons of the Ocular Surface Disease Index(OSDI)score,Schiemer I Test(SIT),Non Invasive Tear Meniscus Height(NITMH),Non Invasive Break Up Time(NIBUT),palpebral margin score,Meibomian Glands Yielding Secretion Score(MGYSS)Corneal Fluorescence Staining Score(CFSS)and Meibomian Glands Loss Score(MGLS)were recorded before and after 1,4,7 and 10 weeks of treatment.A repeated measurement analysis of variance(ANOVA)and test were used for evaluation,the difference was statistically significant with P<0.05.Result:Among 50 patients(100 eyes)with moderate to severe VDT related dry eye,there were 23 males(46%)and 27 females(54%),with an average age of(39.90 ± 8.25)years.The most common symptoms of dry eye were visual fatigue(82%),eye itching(72%),eye pain(70%),foreign body sensation(56%),and photophobia(42%).There was no significant difference between the two groups in terms of gender,age,average daily video time,and pre treatment evaluation indicators(P>0.05).The total effective rates of Group A and Group B were 74.0% and 90.0%,respectively.The treatment effect of Group B was better than that of Group A(P<0.05).After 10 weeks of treatment in both groups,all observation indicators improved.In Group A,after 10 weeks of treatment,OSDI decreased from(58.66 ± 11.72)to(33.20 ± 10.4)points,NITMH increased from(0.16 ± 0.03)mm to(0.19 ± 0.02)mm,NIBUT increased from(4.63 ± 1.61)s to(7.37 ± 1.61)s,SIT increased from(4.82 ± 1.33)mm/5 min to(8.35 ± 1.74)mm/5 min,eyelid margin score decreased from(2.04 ± 0.67)points to(0.88 ± 0.39)points,MGYSS decreased from(2.02 ± 0.69)points to(0.82 ± 0.39)points,CFS decreased from(1.86 ± 1.11)points to(1.36 ± 1.32)points,and MGLS decreased from(2.06 ± 1.06)points to(1.98 ± 1.12)points.In Group B,after 10 weeks of treatment,OSDI decreased from(59.16 ± 15.31)points to(28.10 ± 8.28)points,NITMH increased from(0.15 ± 0.03)mm to(0.21 ± 0.03)mm,NIBUT increased from(4.39 ± 1.80)s to(8.82 ± 1.64)s,SIT increased from(4.66 ± 1.05)mm/5 min to(9.65 ± 2.16)mm/5 min,eyelid margin score decreased from(2.02 ± 0.74)points to(0.58 ± 0.54)points,MGYSS decreased from(2.06 ± 0.74)points to(0.36 ± 0.49)points,CFS decreased from(1.92 ± 1.12 to 0.60 ± 1.05),and MGLS decreased from(2.02 ± 1.19)to(1.88 ± 1.21).After 4 weeks of treatment,Group A showed significant efficacy,while Group B showed efficacy after 1 week of treatment.Both treatment methods gradually improved with the increase of treatment frequency.After 10 weeks of treatment,the improvement of OSDI,NITMH,NIBUT,SIT,palpebral margin score,MGYSS,and CFSS in Group B was better than that in Group A.There was no significant difference in the treatment effect between the MGLS two groups.After treatment,no significant complications were observed in both groups.Conclusion:The main symptoms of moderate to severe VDT related dry eyes are dryness and visual fatigue.Both meibomian gland massage combined with medication and IPL combined with meibomian gland massage and medication can improve the symptoms and signs of moderate to severe VDT related dry eyes,but IPL combined with meibomian gland massage and medication has a faster onset and better effect. |
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