마이봄선기능장애 환자에서 안검미세각질제거의 임상효과
Clinical Efficacy of Microblepharoexfoliation in Meibomian Gland Dysfunction Patients
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목적: 마이봄선기능장애(MGD)환자에서 BlephExTM (Scope Ophthalmics, London, UK)를 이용한 안검미세각질제거 후의 임상적 효과를 객관적 수치를 통해 알아보고자 한다. 대상과 방법: 2018년 10월부터 11월까지 세브란스병원에서 MGD로 진단받은 24명의 양안에 대하여 8-10분간 BlephExTM를 시행하였으며 이들의 안구표면질환지수(OSDI), 눈물막파괴검사, 쉬르머 검사, 각막염색지수, 눈꺼풀 경계 이상, 마이봄선기능장애정도와 Lipiview II 간섭계(TearScience Inc., Morrisville, NC, USA)를 통한 눈물지질층두께를 치료 전과 치료 후 1개월째에 조사하여 비교하였다. 결과: BlephExTM 사용 시 눈물층파괴시간은 치료 전 2.65 ± 1.16초에서 치료 1달 후 3.77 ± 1.80초로 유의미하게 증가하였다(p<0.001). 눈꺼풀 경계 이상은 치료 전 2.98 ± 1.16점에서 2.50 ± 1.01점으로 감소하였으며(p<0.001), 마이봄선기능장애정도 또한 치료 전 21.60 ± 6.95점에서 18.02 ± 6.68점으로 호전 정도가 유의미하였다(p=0.001). OSDI는 치료 전 38.83 ± 17.13점에서 치료 1달 후 18.67 ± 15.01점으로 유의미하게 감소하였다(p<0.001). 결론: BlephExTM를 사용 시 MGD에 따른 환자의 증상 호전뿐만 아니라 눈꺼풀 경계 이상을 비롯한 마이봄선기능장애정도, 눈물막파괴정도가 유의미하게 호전되었고, 이는 스테로이드 안약을 사용시 호전 정도가 명확하였다. 이를 통해 MGD 환자들에게 BlephExTM를 사용하는 것을 치료의 한 가지 방안으로 제시하는 바이다.
Abstract
Purpose: To assess the clinical efficacy of microblepharoexfolication using BlephEx™ (Scope Ophthalmics, London, UK) in meibomian gland dysfunction (MGD) patients. Methods: We performed a prospective study involving 48 eyes of 24 patients who were diagnosed with MGD. All patients were treated with BlephEx™ for 8-10 minutes, and the ocular surface disease index (OSDI), tear break-up time (TBUT), Schirmer’s I test, corneal staining score, lid margin abnormality, MGD score, and lipid thickness layer using the Lipiview II (TearScience, Morrisville, NC, USA) were assessed before treatment and after one month. Results: Significant changes were observed after microblepharoexfoliation using BlephEx™. The TBUT improved from 2.65 ± 1.16 to 3.77 ± 1.80 after 1 month (p < 0.001) and the OSDI improved from 38.83 ± 17.13 to 18.67 ± 15.01 after 1 month (p < 0.001). Before and after 1 month of treatment, the lid margin abnormalities were 2.98 ± 1.16 and 2.50 ± 1.01 (p < 0.001) and the MGD scores were 21.60 ± 6.95 and 18.02 ± 6.68 (p = 0.001), respectively. Conclusions: BlephEx™ improved the patients’ ocular surface symptoms, MGD score, and TBUT. Using steroid eye drops, there was a synergistic effect in improvement. Therefore, using BlephEx™ may be suggested as a treatment option for MGD patients.
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