脉冲光治疗睑板腺功能障碍相关性干眼长期疗效的meta分析OA

Objective To evaluate the efficacy and safety of intense pulsed light(IPL)therapy for dry eye associated with meibomian gland dysfunction(MGD).Methods A computerized search was conducted in the Cochrane Library,Pubmed,Embase,CNKI,CBM,and VIP database to collect clinical randomized controlled trails(RCTs)investigating IPL for MGD-associated dry eye.The quality of the included studies was assessed,and meta-analysis was conducted using RevMan 5.4 software.Results A total of 11 RCTs were included.During the 3-month follow-up,compared with the meibomian gland expression(MGX)group,the IPL combined with MGX group significantly increased schirmer and reduced the ocular surface disease index scores,althought no statistical differ-ences were observed in corneal fluorescein staining and tear meniscus height.Compared with the sham treatment group,IPL signifi-cantly improved meibomian gland expressibility and meiboscore and meibomian gland quality,but no statistical difference was noted in corneal fluorescein staining.During the 6-month follow-up,compared with the MGX group,the IPL combined with MGX group showed significant improvement in meibomian gland yielding secretion score,but no statistical difference was found in schirmer.Compared with the sham treatment group,IPL significantly prolonged tear break-up time and reduced the ocular surface disease index scores.During the 8-month follow-up,the IPL combined with MGX group significantly increased the tear break-up time and improved corneal fiuores-cein staining,althought no significant difference was found in meiboscore and schirmer.At 9-month follow-up,there were no statisti-cally significant differences in tear break-up time,corneal fiuorescein staining,meibomian gland yielding secretion score in the com-bined treatment group.The standard patient evaluation of eye dryness questionnaire scores showed instability during this period.No se-rious adverse events were reported in the available data.Conclusions IPL combined with MGX or IPL alone can effectively improve most signs and symptoms of MGD-associated dry eye over a longer period,but the therapeutic effect gradually decreases after 9 months.