目的：观察人工泪液在应用综合疗法治疗中老年睑板腺功能障碍(Meibomian gland dysfunction，MGD)所致干眼症的治疗前后对比敏感度的变化情况，评价人工泪液对中老年MGD所致干眼症患者视功能的影响。

方法：筛选2014-06-01/2015-01-30我院眼科诊治首次确诊为MGD所致干眼症的中老年患者120例240眼。选取60例120眼正常人为正常组。根据研究纳入标准将120例MGD所致干眼症患者按照数字随机表法随机均分为观察组与对照组。观察组治疗方案：选用人工泪液滴眼液规律滴眼、按摩等局部治疗，联合全身治疗，对照组不使用人工泪液滴眼液，正常组不采取任何治疗。观察组及对照的治疗疗程均为16wk，疗程结束后随访8wk。对观察指标进行观察、比较。

结果：观察组有效率95.8%明显高于对照组83.3%，具有统计学意义(χ²=10.05，P=0.002)； 观察组 BUT(3.14±2.01s)、SⅠt(4.56±1.86mm)与对照组BUT(2.54±1.01s)、SⅠt(3.48±1.23mm)、正常组BUT( 12.85±2.34s)、SⅠt(15.36±2.48mm)，三组间差异有统计学意义，但观察组与对照组组间差异无统计学意义(P>0.05)； 人工泪液使用前观察组、对照组MGD所致干眼患者的低、中、高频敏感度均低于正常人的正常组(P<0.05)； 而使用人工泪液滴眼前，观察组、对照组患者的对比敏感度差异无统计学意义(P>0.05)，观察组患者用人工泪液滴眼后，观察组患者各频段(1.8、3.0、6.0、12、18、24c/d)对比敏感度明显高于对照组患者，具有统计学差异(P<0.05)。

结论：MGD所致干眼症患者在经过综合疗法治疗并辅助以人工泪液滴眼能够明显使干眼症患者的对比敏感度提高、缓解干眼症患者自觉不适症状、提高视觉质量。另外，对比敏感度测定作为一种非接触性的客观检查手段，可为药物治疗中老年MGD所致干眼症的疗效、诊断提供客观依据。

AIM:To observe the change of contrast sensitivity in the middle and the old with dry eyes caused by Meibomian gland dysfunction(MGD)before and after using the artificial tears in the comprehensive therapy and to evaluate the influence of artificial tears on visual function in these patients.

METHODS:One hundred and twenty middle aged and old patients(240 eyes)who were diagnosed with dry eyes caused by MGD for the first time in our department from June 1^st 2014 to January 30^st 2015 were screened. Sixty(120 eyes)normal people were chosen as normal group. The 120 patients enrolled through inclusion criteria were divided into observation group and control group by random digits table. The patients in observation group were treated with artificial tears regularly combined with local massage and systemic treatment. Patients in control group were treated the same as those in the observation group except artificial tears. Normal group did not receive any treatment. The treatments for both observation group and control group lasted for 16wk. The follow-up period after treatment was 8wk. Observe and compare the contrast sensitivity.

RESULTS:Effective rate of observation group was 83.3%, which was obviously higher than that of control group 95.8%,the difference was statistically significant(χ²=10.05,P=0.002). BUT of observation group, control group and normal group were 3.14±2.01s, 2.54±1.01s and 12.85±2.34s respectively. SⅠt of observation group, control group and normal group were 4.56±1.86mm, 3.48±1.23mm and 15.36±2.48mm respectively. There was statistic significance on the two terms among the three groups. But the difference between observation group and control group was not significant. Before treatments, contrast sensitivity at low, middle and high frequency of both observation group and control group was lower than those of normal group(P<0.05),but there was no statistic significance between observation group and control group(P>0.05). After treated by artificial tears, contrast sensitivity of observation group at different frequency(1.8c/d,3.0c/d,6.0c/d,12c/d,18c/d,24c/d)was obviously higher than those of control group, and the difference was statistically significant(P<0.05).

CONCLUSION: After comprehensive therapy combined with artificial tears, the patients with dry eyes caused by MGD have better contrast sensitivity. The subjective symptoms are relieved. The visual acuity is improved. Besides, contrast sensitivity as a non-contact objective examination, can proved evidence to diagnosis and effect evaluation for the patients after treatments.