目的：探讨强脉冲光(IPL)综合治疗睑缘炎相关角结膜病变(BKC)的短期疗效。

方法：选择2020-12/2021-12就诊于沧州爱尔眼科医院确诊为BKC的患者66例66眼(均选择病情严重的一眼进行研究)，根据患者接受的临床治疗方式不同分为两组，对照组30例30眼，治疗组36例36眼，两组均在接受药物(给予0.1%氟米龙滴眼液、0.3%玻璃酸钠滴眼液、妥布霉素地塞米松眼膏点眼)治疗后1wk，以眼表状态作为基线水平，对照组继续进行药物治疗(给予0.1%氟米龙滴眼液、0.3%玻璃酸钠滴眼液点眼)，治疗组在药物治疗基础上需在医院内定期进行IPL综合治疗(雾化熏蒸+IPL+睑板腺按摩+睑缘清洁+冷敷)，每2wk 1次，共治疗4次。在药物治疗1wk后、IPL第1次治疗前(基线水平V1)和IPL第3次治疗前(V2)、IPL第4次治疗后2wk(V3)对两组患者进行随访，收集眼表疾病指数(OSDI)、裂隙灯下观察睑缘形态、睑板腺(MG)分泌物性质和分泌物排出难易程度、泪膜破裂时间(NIBUT)、眼红指数及角膜荧光素染色等数据，同时检查最佳矫正视力(BCVA)、眼压、眼前节及眼底，观察有无并发症的发生。

结果：两组患者治疗前OSDI、睑缘形态、MG分泌物性质和分泌物排出难易程度、NIBUT、眼表充血、角膜荧光素染色各项评分相比均无差异(P>0.05)。在V2、V3时，两组患者OSDI、睑缘形态、MG分泌物性质和分泌物排出难易程度、眼表充血分析、角膜荧光素染色各项评分均较治疗前(V1)下降，NIBUT较治疗前提高(均P<0.05)，组间比较有差异(P<0.05)，治疗组各项观察指标改善更明显。所有患者均未见明显并发症发生。

结论：IPL综合治疗可以减轻眼表炎症，改善睑板腺功能，可作为BKC物理治疗的新选择。

METHODS: A total of 66 patients(66 eyes)diagnosed with BKC in Cangzhou Aier Eye Hospital from December 2020 to December 2021 were selected(All selected the more severe eye for research). They were divided into two groups according to the different clinical treatment, with 30 cases(30 eyes)in control group and 36 cases(36 eyes)in treatment group. Both groups were administrated for 1wk(0.1% fluorometholone eye drops, 0.3% sodium hyaluronate eye drops and tobramycin dexamethasone eye ointment). Ocular surface state was taken as the baseline level. The control group continued to receive drugs(0.1% fluorometholone eye drops and 0.3% sodium hyaluronate eye drops), while the treatment group is required to undergo regular IPL in the hospital on the basis of drug treatment(atomization fumigation+IPL+meibomian gland massage + meibomian margin cleaning+cold compress), once every 2wk, for a total of 4 times. The patients in both groups were followed up at 1wk after drug treatment, before the first IPL treatment(V1), before the third treatment(V2)of IPL, and at 2wk after the fourth treatment(V3)of IPL, respectively. Data including ocular surface disease index(OSDI), the morphology of meibomian margin under the slit lamp, the nature of meibomian gland(MG)secretion, the difficulty of excretion of MG secretion, non-invasive tear film break-up time(NIBUT), red eye index and corneal fluorescent staining were collected. Moreover, the best corrected visual acuity(BCVA), intraocular pressure, anterior segment and fundus were examined to observe the occurrence of complications.

RESULTS: There was no statistically significant difference in the indexes of the patients in both groups before treatment, including OSDI, morphology of meibomian margin, nature of MG secretion, the difficulty of excretion of MG secretion, NIBUT, ocular surface hyperemia and corneal fluorescein sodium staining(P>0.05). In V2 and V3, the indexes of the patients in both groups, including OSDI, morphology of meibomian margin, nature of MG secretion, the difficulty of excretion of MG secretion, ocular surface hyperemia and corneal fluorescein sodium staining, were lower than those before treatment(V1), while the NIBUT was longer than that before treatment, the differences were statistically significant(all P<0.05). There was difference between the groups(P<0.05). Those indexes improved more obvious in the treatment group. No obvious complications occurred in all patients.

CONCLUSION: IPL comprehensive treatment have better effect on reducing the inflammation of ocular surface, and improving the function of MG, and it can be used as a new option for physical therapy of BKC.