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Effect of Intense Regulated Pulse Light on Thickness of Tear Film Lipid Layer and Dry Eye Syndrome

조절펄스광선조사가 눈물막 지질층 두께 및 안구건조증에 미치는 효과

  • Received : 2018.07.26
  • Accepted : 2018.11.27
  • Published : 2018.12.15

Abstract

Purpose: To evaluate the clinical effect of intense regulated pulse light (IRPL) and changes in tear film thickness in dry eye patients. Methods: A retrospective study was conducted on 25 patients with Meibomian gland dysfunction who had subjective dry eye discomfort and whose tear film break-up time (TBUT) was < 10 seconds. All patients were treated with IRPL three times on days 1, 15, and 45. TBUT, Schirmer 1 test results, cornea staining score with fluorescein, ocular surface disease index (OSDI), and lipid layer thickness were measured and compared before and after the procedure. Results: TBUT was significantly increased from $3.7{\pm}1.2s$ to $4.4{\pm}2.1s$ after IRPL (p = 0.03). Schirmer 1 test and cornea staining scores changed significantly (p < 0.01 and p = 0.01, respectively). OSDI also showed a statistically significant improvement from $39.5{\pm}17.5points$ to $30.4{\pm}18.7points$ (p = 0.01). However, no significant difference in lipid layer thickness was observed (p = 0.49). Conclusions: IRPL is an effective treatment modality to improve TBUT, Schirmer 1 test scores, cornea staining scores, and subjective dry eye symptoms.

목적: 건성안 환자에서 조절펄스광선조사가 미치는 임상 효과 및 눈물막지질층 두께 변화에 대하여 알아보고자 하였다. 대상과 방법: 건성안에 대한 주관적인 불편감을 호소하는 환자 중 마이봄샘기능부전 소견을 보이며, 눈물막파괴시간이 10초 이하인 25명을 대상으로 후향적 연구를 시행하였다. 모든 대상자에 대한 조절펄스광선조사는 시술 당일, 15일, 45일 총 3회에 걸쳐 시행되었으며, 시술 전후 눈물막파괴시간, 쉬르머검사, 안구표면염색점수, 안구표면질환지수(Ocular Surface Disease Index, OSDI) 및 눈물막 지질층의 두께를 측정하여 비교 분석하였다. 결과: 조절펄스광선조사 시술 후 눈물막파괴시간은 $3.7{\pm}1.2$초에서 $4.4{\pm}2.1$초로 증가되어 통계적으로 유의한 차이를 보였으며(p=0.03), 쉬르머 검사 및 안구표면염색 점수 결과는 통계적으로 유의한 차이를 보였다(p<0.01, p=0.01). OSDI는 $39.5{\pm}17.5$점에서 $30.4{\pm}18.7$점으로 통계적으로 유의한 향상을 보였다(p=0.01). 눈물막지질층 두께는 통계적으로 유의한 변화를 보이지 않았다(p=0.49). 결론: 조절펄스광선조사 시술은 눈물막파괴시간, 쉬르머검사, 안구표면염색점수 및 주관적인 건성안 증상을 개선시키는 효과적인 치료 방법이라 생각된다.

Keywords

References

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  1. Safety and Efficacy of Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction vol.10, pp.5, 2018, https://doi.org/10.12677/acm.2020.105116