关键词: 睑板腺功能障碍, 糖皮质激素, 干眼症

Abstract: Objective To investigate the treatment effectiveness of antibiotics alone or combined with glucocorticoid in patients with meibomian gland dysfunction (MGD) related dry eye. Design Prospective comparative case series. Participants 42 MGD related dry eye outpatients (84 eyes) in Second Affiliated Hospital of Zhejiang University School of Medicine in May 2012. Method The experimental group, 22 patients (44 eyes), were treated with the tobramycin and dexamethasone eye ointment +tears naturale eye drops+ local physical therapy of meibomian gland; the control group: 20 patients (40 eyes) were treated with the tobramycin eye ointment + tears naturale eye drops + local physical therapy of meibomian gland for 1 month, respectively． Meibomian glands function and correlated indexes of dry eye were investigated before treatment and at 1st, 2nd and 4th week after treatments. Slit lamp examination (the changes of limbus palpebralis and meibomian glands orifices, secretion characteristics, the difficulty of lipid excretion were evaluated for MGD degree); the symptom score, tear break-up time test (TBUT), corneal fluorescein staining (CFS), and Schirmer I test (SIt) were performed. Main Outcome Measures Secretion characteristics, the difficulty of lipid excretion,  the symptom score, TBUT, CFS, and SIt. Results Before treatment，there were no statistical difference in age, the course of disease, MGD physical signs and dry eye related indexes between experimental group and control group (all P>0.05). At each time point after treatment, the secretion characteristics, the difficulty of lipid excretion, and the subjective symptom score were all decreased obviously than before treatment in both groups; and TBUT increased significantly (all P<0.05). The CFS at 2nd and 4th week after treatment were significantly reduced compared with before treatment (all P<0.05). At 1st week and 2nd week after treatment, secretion characteristics and the difficulty of lipid excretion scores were significantly reduced in experimental group than in control group (all P<0.05). Significant increase of TBUT was also observed at all time points after treatment in experimental group than in control group (all P<0.05). Conclusion The anti-inflammatory treatments with antibiotics alone or comined with glucocorticoid were both effective for meibomian gland dysfunction related dry eye. The glucocorticoid can more significantly improve the symptoms and signs for patients with meibomian gland dysfunction related dry eye.

Key words: meibomian gland dysfunction, glucocorticoid, dry eye