目的：评估强脉冲激光(IPL)治疗中重度睑板腺功能障碍(MGD)相关性干眼患者的短期疗效及对心理状况的影响。

方法：自身前后对照。收集2018-10/2019-10就诊于武汉大学人民医院眼科门诊的中重度MGD患者25例50眼，给予IPL联合睑板腺按摩治疗。于治疗前和治疗一个疗程后1mo评估患者症状、体征及心理状态的变化，采用眼表疾病指数(OSDI)问卷评分标准评估患者症状，泪液分泌试验(SⅠt)、泪河高度、平均泪膜破裂时间(Mean BUT)、睑板腺缺失程度以及欧卡斯双通道系统测量平均散射指数(Mean OSI)来评估患者的体征，使用焦虑自评量表(SAS)和流调用抑郁自评量表(CES-D)来评估患者的心理状态。

结果：患者治疗前后OSDI评分(58.36±10.34 vs 49.12±8.05分)、SⅠt(5.64±1.6 vs 8.24±1.71mm/5min)、泪河高度(0.19±0.04 vs 0.23±0.04mm)、Mean BUT(5.65±1.72 vs 7.06±1.84s)、Mean OSI(0.89±0.24 vs 0.75±0.23)、睑板腺缺失程度评分(2.56±0.58 vs 1.84±0.85分)、SAS评分(46.92±8.49 vs 40.2±8.01分)，CES-D评分(21.04±6.11 vs 16.92±4.24分)，所有指标治疗前后差异均有统计学意义(P<0.01)。OSDI评分与Mean BUT呈负相关(r_s=-0.511，P<0.01)，与Mean OSI呈正相关(r_s=0.479，P<0.05)，OSDI评分与SAS评分及CES-D评分均呈正相关(r_s=0.775，0.856，均P<0.01)，SAS评分与SⅠt和Mean BUT呈负相关(r_s=-0.653，-0.713，均P<0.01)，SAS与CES-D评分呈正相关(r_s=0.730，P<0.01)。

结论：短期观察IPL治疗中重度MGD相关性干眼安全、有效，治疗后患者干眼症状、体征及心理状态得到不同程度的缓解，患者的抑郁和焦虑与眼表症状相关。

METHODS:The situations before and after of oneself were compared. From October 2018 to October 2019, 25 patients(50 eyes)with moderate to severe MGD who were admitted to the Ophthalmology Development of Wuhan University People's Hospital were collected. They were given intense pulse laser combined with meibomian gland massage therapy. Before the treatment and one month after the one course of treatment, the changes in symptoms, signs, and mental status of patients were evaluated. The ocular surface disease index(OSDI)questionnaire scoring criteria were used to assess patients' symptoms. Through tear secretion test(S I t), tear meniscus height, mean tear break-up time(Mean BUT), meibomian gland loss degree, and mean scattering index(Mean OSI)measured by Ocassian dual-channel system, the signs of patients were evaluated. By using the Self-Rating Anxiety Scale(SAS)and the center for epidemiological studies depression scale(CES-D), the mental state of the patients was evaluated.

RESULTS: The results of the patients before and after treatment were as follows, OSDI score(58.36±10.34 vs 49.12±8.05), SⅠt(5.64±1.6 vs 8.24±1.71mm/5min), tear meniscus height(0.19±0.04 vs 0.23±0.04mm), Mean BUT(5.65±1.72 vs 7.06±1.84s), Mean OSI(0.89±0.24 vs 0.75±0.23), meibomian gland loss degree score(2.56±0.58 vs 1.84±0.85), SAS score(46.92±8.49 vs 40.2±8.01), CES-D score(21.04±6.11 vs 16.92±4.24), all indicators had statistical significance(P<0.01). OSDI score was negatively correlated with Mean BUT(r_s=-0.511, P<0.01), and positively correlated with Mean OSI(r_s=0.479, P<0.05). OSDI score was positively correlated with SAS score and CES-D score(r_s=0.775, 0.856, P<0.01). SAS score was negatively correlated with SⅠt and Mean BUT(r_s= -0.653, -0.713, P<0.01). SAS was positively correlated with CES-D score(r_s=0.730, P<0.01).

CONCLUSION: IPL is safe and effective for short-term observation of moderate to severe MGD-related dry eye. After treatment, the dry eye symptoms, signs and mental state of patients can be relieved with different degrees. There is the correction between the depression and anxiety of patients and ocular surface symptoms.