热脉冲治疗对白内障手术前后干眼症有效吗?系统回顾和荟萃分析。

Clinical ophthalmology (Auckland, N.Z.) Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI:10.2147/OPTH.S498869
Kai-Yang Chen, Hoi-Chun Chan, Chi Ming Chan
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引用次数: 0

摘要

背景:睑板腺功能障碍(MGD)是蒸发性干眼病(DED)的主要原因,由于手术创伤和炎症,白内障手术往往会加重这种疾病。热脉冲疗法(TPT)旨在增强睑板腺功能,缓解干眼症状。我们进行了一项系统回顾和荟萃分析,以评估TPT治疗白内障手术相关干眼症状的有效性。方法:于2024年12月在PubMed、ScienceDirect、CINAHL和Cochrane中央对照试验登记中心进行系统检索,以确定TPT治疗白内障手术相关干眼症状疗效的原始研究。纳入研究的质量采用干预措施非随机研究的偏倚风险(Risk of Bias)工具进行评估,结果通过Cochrane Collaboration开发的Robvis 2.0工具可视化。结果:检索得到365条记录,其中7项研究符合本荟萃分析的纳入标准。分析的主要结局包括睑板腺产液分泌(MGYLS)评分、泪液破裂时间(TBUT)、眼表疾病指数(OSDI)评分和脂质层厚度(LLT)。荟萃分析显示,TPT的效果中等,MGYLS评分(Cohen’s d = 0.29, p = 0.033)和TBUT (Cohen’s d = 0.15, p = 0.029)有轻微但具有临床意义的改善。然而,对OSDI评分和LLT的影响无统计学意义。研究的异质性各不相同,一些结果表现出相当大的可变性。结论:TPT对白内障术后干眼症状患者的MGYLS评分和TBUT有中度且有临床意义的改善,但对OSDI评分和LLT的改善没有统计学意义。研究质量的可变性和异质性突出表明需要精心设计的高质量研究来证实这些发现,并评估白内障手术前后TPT治疗效果的持久性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is Thermal Pulsation Therapy Effective for Dry Eyes Before and After Cataract Surgery? A Systematic Review and Meta-Analysis.

Background: Meibomian gland dysfunction (MGD) is a primary cause of evaporative dry eye disease (DED), which is often exacerbated by cataract surgery due to surgical trauma and inflammation. Thermal pulsation therapy (TPT) aims to enhance meibomian gland function and relieve dry eye symptoms. We conducted a systematic review and meta-analysis to evaluate the effectiveness of TPT in managing dry eye symptoms associated with cataract surgery.

Methods: A systematic search was performed in December 2024 across PubMed, ScienceDirect, CINAHL, and the Cochrane Central Register of Controlled Trials to identify original research on the efficacy of TPT in addressing cataract surgery-related dry eye symptoms. The quality of the included studies was evaluated using the Risk of Bias in Non-Randomized Studies of Interventions tool, with results visualized through the Robvis 2.0 tool developed by the Cochrane Collaboration.

Results: The search yielded 365 records, of which seven studies met the inclusion criteria for this meta-analysis. Key outcomes analyzed included the meibomian gland yielding liquid secretion (MGYLS) score, tear break-up time (TBUT), ocular surface disease index (OSDI) score, and lipid layer thickness (LLT). The meta-analysis revealed a moderate effect of TPT, with a small but clinically significant improvement observed in MGYLS scores (Cohen's d = 0.29, p = 0.033) and TBUT (Cohen's d = 0.15, p = 0.029). However, the effects on OSDI scores and LLT were not statistically significant. Study heterogeneity varied, with some outcomes exhibiting considerable variability.

Conclusion: TPT provides moderate and clinically meaningful improvements in MGYLS scores and TBUT for patients experiencing dry eye symptoms after cataract surgery, although improvements in OSDI scores and LLT did not achieve statistical significance. The variability in study quality and heterogeneity highlights the need for well-designed, high-quality research to confirm these findings and evaluate the durability of TPT's therapeutic effects both before and after cataract surgery.

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