Randomized Controlled Trial of Intradermal Pressing Needle Plus Artificial Tears for Perimenopausal Dry Eye

To investigate the efficacy of umbilical cord serum eyedrops after laser epithelial keratomileusis (LASEK). Sixty patients (120 eyes) with myopia who underwent LASEK were studied. Thirty-two patients (64 eyes) were treated with 20% umbilical cord serum eyedrops in combination with conventional treatment (group A), and 28 patients (56 eyes) received conventional treatment only (group B). Epithelial healing time was analysed. Visual acuity, refraction, haze score (0-4) and tear film and ocular surface parameters were evaluated at 1, 2, 4 and 12 weeks after LASEK. The concentration of transforming growth factor (TGF)-β1 in tears was measured with ELISA at 1 week after LASEK. No significant differences in visual acuity and refraction were found between groups. The mean time to epithelial healing was 3.53 ± 1.19 days in group A and 3.91 ± 1.41 days in group B (p = 0.18). The mean haze scores at 2 and 4 weeks were 0.59 ± 0.80 and 0.31 ± 0.54 in group A and 1.06 ± 0.91 (p = 0.02) and 0.69 ± 0.78 (p = 0.03) in group B. Four and 12 weeks after LASEK, tear film break-up time was longer and keratoepitheliopathy score was lower in group A compared with group B. The mean concentration of TGF-β1 was lower in group A compared with group B (p = 0.01). Application of 20% umbilical cord serum eyedrops in addition to conventional treatment after LASEK can reduce early postoperative corneal haze and improve tear film and ocular surface parameters.

To determine whether tear osmolarity contributes to the assessment of the ocular surface in soft contact lens (CL) wearers. Prospective, case-control series in 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination with a tear osmolarity test (TearLab System), conjunctival impression cytology and meibomian lipid sampling. Symptoms, break-up time (BUT), tear osmolarity, conjunctival expression of HLA-DR and meibomian fatty acid composition were evaluated. Tear osmolarity did not differ between controls and CL wearers (p= 0.23). Flow cytometry results expressed in antibody-binding capacity (ABC) units and percentage of positive cells revealed a significant difference between the intolerant CL wearer group and the control group (p< 0.0001). Comparisons between tolerant and intolerant CL wearers showed only a significant difference for mean fluorescence levels expressed in ABC units (p< 0.0001). The BUT was significantly shorter in intolerant and tolerant CL wearers subjects than in healthy subjects (p< 0.0001), whereas there was no significant difference in meibomian fatty acid composition (p= 0.99) between the two groups. Contact lens wear is responsible for ocular surface alterations whose patterns are very similar to those reported in early dry-eye syndrome. However, tear osmolarity was not modified in these selected CL wearers. The yield of tear osmolarity with TearLab™ in assessing ocular surface disorders in CL wearers deserves further investigation.

To observe the effects of subcutaneous embedding of thumb-tack needle combined with mytear and simple mytear on tear film in patients with dry eye. Eighty patients of dry eye (160 eyes) were randomly divided into an observation group and a control group, 40 cases in each group. The 0.1% sodium hyaluronate eye drop (alice) was applied in the control group, four times per day for two weeks. On the basis of the control group, the subcutaneous embedding of thumb-tack needle was used at ① Cuanzhu (BL 2), Sizhukong (SJ 23), Sibai (ST 2), ② Yintang (EX-HN 3), Yuyao (EX-HN 4), Taiyang (EX-HN 5). The two groups of acupoints were used alternately. The thumb-tack needle was placed for 2 to 3 days, once a week for two weeks. The subjective symptom score, Schirmer Ⅰ test (SⅠT), tear break-up time (BUT) and corneal fluorescein staining (CFS) were compared before treatment, after treatment and during 2-week follow-up visit in the two groups. The effects of the two groups were compared. Compared before treatment, the subjective symptom score and CFS were reduced but SⅠT and BUT were increased after treatment and during follow-up visit in the two groups (all P<0.05), which in the observation group were superior to those in the control group (all P<0.05). The total effective rate was 90.0% (36/40) in the observation group, which was superior to 85.0% (34/40) in the control group (P<0.05). The subcutaneous embedding of thumb-tack needle could increase the amount of SIT, prolong BUT and repair pathological damage of cornea, which could relieve the symptoms of dry eye and improve visual quality.

Objective: To investigate the clinical characteristics of symptoms and signs of ocular surface lesions in dry eye patients with type 2 diabetes mellitus (T2DM) of different disease durations. Methods: A cross-sectional study was conducted. Consecutive T2DM patients complicated with dry eye who visited the Special Clinic for Diabetic Ocular Surface Diseases at Qingdao Eye Hospital, Shandong First Medical University from January 2020 to December 2024 were enrolled as the T2DM group. Dry eye patients without T2DM from the Dry Eye Clinic and age-and gender-matched healthy volunteers were recruited as the non-T2DM group and control group, respectively. The T2DM group was further divided into four stages according to disease duration: Stage Ⅰ (duration≤5 years), Stage Ⅱ (5 years<duration≤10 years), Stage Ⅲ (10 years<duration≤20 years), and Stage Ⅳ (duration>20 years). Ocular symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Ocular surface function was assessed by corneal sensitivity (CS), corneal fluorescein staining (CFS) score, Schirmer Ⅰ test (SⅠT), tear meniscus height (TMH), non-invasive first tear film break-up time (NIKf-BUT), non-invasive average tear film break-up time (NIKav-BUT), lipid layer thickness (LLT), and meibomian gland loss (MGL) grading score. Anterior segment optical coherence tomography was used to measure central corneal epithelial thickness (CCET) and central corneal thickness (CCT). In vivo confocal microscopy was performed to detect corneal nerve fiber parameters. Spearman's rank correlation analysis was used to evaluate the correlations between variables. Results: A total of 278 T2DM patients (556 eyes) were enrolled in the T2DM group, with a mean age of (60.25±8.71) years, a male-to-female ratio of 117∶161, and a mean disease duration of (11.09±8.02) years; among them, 84 cases were Stage Ⅰ, 81 cases Stage Ⅱ, 90 cases Stage Ⅲ, and 23 cases Stage Ⅳ. The non-T2DM group included 60 patients (120 eyes), with a mean age of (58.52±7.93) years and a male-to-female ratio of 23∶37. The control group comprised 53 healthy volunteers (106 eyes), with a mean age of (58.79±5.73) years and a male-to-female ratio of 21∶32. There were no statistically significant differences in age and gender distribution among the three groups (all P>0.05). Compared with the control group, the T2DM group showed significantly higher OSDI score (31.58%±20.56%), MGL grading score (3.59±0.95) and CFS score (1.84±3.01) (all P<0.05); while significantly lower SⅠT [(5.79±3.10) mm], NIKf-BUT [(5.81±3.14)s], NIKav-BUT [(9.31±4.85)s], LLT [(60.48±16.6) nm], CCET [(51.95±5.56) μm], CS [(56.9±8.30) mm], corneal endothelial cell density [(2 596±465.38)/mm²], and all corneal nerve parameters (including paracentral corneal nerve fiber density and length, etc.) (all P<0.05). Compared with the non-T2DM group, the T2DM group had significantly lower LLT, CCET, CS, OSDI score and all corneal nerve parameters, along with significantly higher MGL grading score and CFS score (all P<0.05); no statistically significant differences were found in SⅠT, NIKf-BUT and NIKav-BUT between the two groups (all P>0.05). In T2DM patients with disease duration≤5 years, compared with the control group, the OSDI score (23.98%±18.21%) and MGL grading score (3.35±0.91) were significantly increased, while SⅠT [(5.65±2.93) mm], LLT, NIKf-BUT and all corneal nerve parameters were significantly decreased (all P<0.05); meanwhile, compared with the non-T2DM group, this subgroup had significantly lower OSDI score and significantly higher MGL grading score (all P<0.05). When the disease duration exceeded 10 years, the OSDI score further increased to be comparable with that of the non-T2DM group, and NIKf-BUT [(5.44±2.92)s], CFS score (2.75±3.25), CCET [(51.36±4.17) μm], CS [(55.21±8.02) mm] showed statistically significant differences compared with both the control group and non-T2DM group (all P<0.05). Spearman's correlation analysis indicated that disease duration was significantly positively correlated with OSDI score, MGL grading score and CFS score, and significantly negatively correlated with NIKf-BUT, CCET, CS and all corneal nerve parameters (all P<0.05). Conclusions: Ocular surface lesion characteristics vary among dry eye patients with T2DM of different disease durations: decreased tear secretion, meibomian gland dysfunction and corneal nerve structural changes occur when the disease duration is ≤5 years, and corneal hypoesthesia and epithelial thinning develop when the duration exceeds 10 years, with lesions gradually worsening as the disease progresses. Compared with non-diabetic dry eye, significant differences exist in meibomian gland function, corneal nerves and epithelial barrier between the two groups.

To compare the clinical efficacy between penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops and sodium hyaluronate eye drops alone for the treatment of dry eye. A total of 156 patients (312 eyes) with dry eye were randomly assigned to an observation group and a control group, with 78 patients (156 eyes) in each group. The control group was treated with sodium hyaluronate eye drops, one drop per eye, four times daily, for 4 weeks. In addition to the sodium hyaluronate treatment, the observation group received penetrating needling of three eye acupoints. Acupoints included bilateral Cuanzhu (BL2), Sizhukong (TE23), Sibai (ST2), and Jingming (BL1). Needling was performed once daily, four times a week, for 4 weeks. The subjective ocular symptom scores, neuropathic pain symptom inventory-eye (NPSI-Eye) scores, ocular surface disease index (OSDI) scores, corneal fluorescein staining (FL) scores, tear break-up time (BUT), SchirmerⅠtest (SⅠT), central tear meniscus height (TMH), and tear levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. After treatment, both groups showed significant improvements in subjective ocular symptom scores, NPSI-Eye scores, OSDI scores, FL scores, and reductions in tear IL-6 and TNF-α levels (P<0.01). Additionally, BUT, SⅠT, and TMH were increased significantly in both groups (P<0.01). After treatment, the subjective ocular symptom scores, NPSI-Eye score, OSDI score, FL score, and tear levels of IL-6 and TNF-α in the observation group were lower than those in the control group (P<0.01, P<0.05), while BUT, SⅠT, and TMH were significantly improved compared to the control group (P<0.01). The markedly effective rate and total effective rate in the observation group were 83.3% (65/78) and 100.0% (78/78), respectively, which were higher than 52.6% (41/78, P<0.01) and 92.3% (72/78, P<0.05) in the control group. The penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops can effectively alleviate symptoms of dry eye, reduce inflammatory response, and has superior efficacy to sodium hyaluronate eye drops alone.

Dry eye is a common eye disease. Artificial tears supplements are widely used for the treatment of dry eyes. However, multiple adverse effects have been observed in patients receiving long-term treatment with artificial tears, which may affect the therapeutic effect. To analyze the characteristics of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) levels in patients with dry eye and the therapeutic effect of artificial tears combined with cyclosporine A. A total of 124 dry eye patients treated at The First People's Hospital of Xining from April 2020 to April 2022 were selected as the observation group, while 20 healthy individuals served as the control group during the same period. Levels of inflammatory markers, including IL-1β, IL-6, and TNF-α, were analyzed. The observation group was further divided into a study group and a control group, each consisting of 62 patients. The control group received artificial tears, whereas the study group received a combination of artificial tears and cyclosporine A. Inflammatory markers, Schirmer's test (SIT), tear break-up time (TBUT), corneal fluorescein staining (CFS), National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) scores, and adverse events (AEs) were compared between the two groups. The observation group exhibited significantly elevated serum levels of IL-1β, IL-6, and TNF-α in comparison to the healthy group. Following treatment, the study group demonstrated substantial reductions in IL-1β, IL-6, and TNF-α levels relative to the control group. Moreover, after treatment, the study group experienced a marked decrease in CFS scores and significant increases in both SIT and BUT levels when compared to the control group. Additionally, significant improvements were observed in the primary symptom of dry eye and secondary symptoms such as photophobia, foreign body sensation, fatigue, red eye, and burning sensation within the study group. Furthermore, post-treatment NEI-VFQ-25 scores across all dimensions exhibited significant enhancements in the study group compared to the control group (P < 0.05). It is noteworthy that significant AEs were reported in both groups throughout the treatment period. Cyclosporine A combined with artificial tears is effective in treating dry eye, yielding enhanced outcomes by improving SIT and TBUT levels, reducing CFS scores, and ameliorating vision-related quality of life.

Objective To compare the tear related indexes of patients with type-2 diabetes and the healthy subjects, analyze the functions of tear film of these two groups and provide significant theoretical evidences for the causes of the increased prevalence of dry eye in patients with type-2 diabetes and their pathogenesis. Methods A case-control study was designed.During the epidemiological investigation of dry eye in communities, 79 patients with diabetes and 74 normal healthy subjects were randomly selected as participants in this case-contol study.Dry eye tests including tear film break-up time (BUT), SchirmerⅠtest (SⅠt) and corneal fluorescein staining were performed.The tears were collected to detect mucoprotein-5AC (MUC-5AC), matrix metalloproteinase 9 (MMP-9), receptor of advanced glycation endproducts (RAGEs) and the content of insulin.The diagnosis standard referred to Experts Consensus on Clinical Diagnosis and Treatment of Dry Eye published in 2013.The study was followed the Declaration of Helsinki.This study protocol was approved by Medical Ethics Committee of the Shanghai General Hospital, Shanghai Jiaotong University(No.2016KY005), and written informed consent was obtained from all subjects. Results There were significant differences between 79 diabetes patients and 74 normal healthy subjects in the value of BUT, SⅠt and corneal fluorescein staining (all at P<0.05). The value of BUT and SⅠt in patients with diabetes were lower than those in the control group, while the corneal fluorescein staining scores of patients were higher than those of normal healthy subjects, with significant differences (P<0.05). In addition, compared with normal healthy subjects, the diabetic patients were higher in the value of MMP-9 and RAGEs, but lower in the content of insulin and MUC-5AC, with significant differences (P<0.05). There were significant differences in gender, diabetes duration, MMP-9, and MUC-5AC between the dry and non-dry eyes in the diabetic group (P<0.05). Women were more likely to develop dry eyes with a significant difference (t=4.35, P=0.04). The duration of diabetes in dry eye group was higher than that in non-dry eye group, with a significant difference (t=2.56, P=0.01); the value of MMP-9 in dry eye group was (1 052.37±157.68)pg/ml, which was significantly higher than that in non-dry eye group ([459.11±258.67]pg/ml)(t=11.92, P<0.01); the value of MUC-5AC in dry eye group was (867.83±121.82)pg/ml, which was significantly lower than in non-dry eye group ([972.93±153.52] pg/ml)(t=-3.30, P<0.01). There was no statistical difference in age and insulin between the two groups.Pearson correlation analysis showed that MMP-9 was negatively correlated with BUT (r=-0.349, P<0.01), and positively correlated with corneal fluorescein staining (r=0.181, P=0.026). MUC-5AC was positively correlated with SⅠt (r=0.367, P<0.01). Conclusions Dry eye prevalence is significantly related with the decrease in MUC-5AC and the increase in MMP-9 in community-based diabetic patients. Key words: Diabetes mellitus; Tear index detection; Tear film function; Dry eye

Objective To observe the effect of Mingmujili pills on dry dye syndrome. Methods One hundred and fourteen patients with dry eye syndrome were randomly divided into control group and observation group. The patients in the control group received artificial tears treatment, and the patients in the observation group received artificial tears and Mingmujili pill treatment. The tear film break-up time, tear secretion (Schirmer I test values), corneal and conjunctival fluorescein staining score and efficacy between the two groups was compared. Results After treatment, the tear film breakup times significantly prolonged, Schirmer I test values significantly increased, corneal and conjunctival fluorescein staining scores significantly decreased in the two groups, and the effect in the obervation group was significantly better than that in the control group (P<0.05). The total effective rate in the control group was 73.68%, the total effective rate in the observation group was 92.98%, and the difference between the two groups was significant (χ2=8.485, P=0.014). Conclusions Mingmujili pills can increase tear film stablity, promote tear secretion, reduce corneal and conjunctival injury, and the effect is certain. Key words: Dry eye syndrome; Mingmujili pills; Artificial tears; Clinical observation

Objective To investigate the early changes in tear film after vitreous microsurgery,to compare the postoperative impact of 23-gauge and 25-gauge vitreous microsurgery on tear film.Methods Eighty-six eyes of 86 patients who underwent 23-gauge or 25-gauge vitreous microsurgery monoculady between March 2009 and July 2009 were enrolled in this prospective case series study.The contralateral eyes were regarded as the control group. Among them, 35 eyes each underwent 25- combined 23-gauge surgery (group A), another 35 eyes underwent 25-gauge vitrectomy (group B),and another 16 eyes underwent 23-gauge vitrectomy (group C). Symptoms of discomfort, break-up time (BUT), Schirmer I test (SIT) and corneal fluorescein staining (CFS) were recorded before and after surgery in all patients (86 patients with 172 eyes), and the data from all ophthalmologic examinations were collected. Data were analyzed with a Kruskal-Wallis, a Wilcoxon, an one-way ANOVA and an independent samples t test. Results Nine patients complained of foreign body sensation, burning, or lacrimation with significantly increased SIT (P=0.001) at day 1 and CFS scores (Z=-3.782,P＜0.05) at days 3 postoperatively. Obviously decreased BUT was recorded at day 1 and day 3 postoperatively, BUT recovered significantly 10 days postoperatively (P=0.001). In the subjective scores for symptoms of discomfort and SIT results in the contralateral eyes, no significant changes were found at any follow-up examination, the differences for CFS and BUT were significant 10 days after surgery. Compared to contralateral eyes, all dry eye test values were significantly worse at day 1 and davs 3 postoperatively in the surgical eyes (Z=-5.470, -5.011; t=-4.968, -5.184; t=4.452, 3.963; P＜0.05).CFS values were different at each follow-up examination (Z=-6.229, -5.780, -5.018, -4.379, -2.374,P＜0.05). There were no differences in tear film in both eyes between group A, group B and group C at any follow-up examination. Conclusion The stability of tear film can be affected in the early postoperative period after vitreous microsurgery. Dry eye symptoms and tear film lesions are the main early symptoms and complications after vitreous microsurgery. No statistical significance in tear film changes is found when the 23-gauge and 25-gauge vitreous microsurgery groups are compared. Key words: Vitrectomy; Surgical procedure,minimally invasive; Tear film; Xerophthalmia

Purpose:To evaluate and compare the efficacy of autologous platelet-rich plasma (aPRP) eye drop and artificial tear (AT) eye drop in moderate to severe symptomatic dry eye disease (DED).Methods:This prospective interventional study included 121 eyes of 61 patients of moderate to severe DED. Patients were divided into aPRP (31 patients) and AT (30 patients) group. Ocular Surface Disease Index (OSDI) score, tear film breakup time (TBUT) (s), corneal fluorescein staining (CFS) score, and Schirmer test score (mm) of both the groups were evaluated and compared pre-treatment and post-treatment at the end of 3 months.Results:The mean age of the aPRP group and AT group was 52.8 ± 12.8 years and 55.5 ± 13.4 years, respectively. At the end of 3 months, OSDI score reduced more in the aPRP group as compared to AT group, and the mean difference (−22.7) was statistically significant (P < 0.001). There was no significant difference in post-treatment Schirmer test score between the two groups (P = 0.44). Post-treatment improvement in TBUT and CFS score in the aPRP group was significantly higher in the aPRP group as compared to that in the AT group (P < 0.05). Bruising at the site of blood withdrawal was noted in two patients in the aPRP group.Conclusion:aPRP is safe and more effective than AT in treating patients with moderate to severe symptomatic DED.

Previous studies have shown that ovariectomy (OVX) induces lacrimal gland regression and that androgens are implicated. This study explored the effects of estrogen and androgen on tear secretion and matrix metalloproteinase 2 (MMP-2) expression in lacrimal glands of ovariectomized rats. Sixty-four adult female Wistar rats were randomly divided into three groups (control, sham operated, and OVX). Bilateral OVX was performed in the OVX group. After 5 months, the OVX group was further divided into six subgroups receiving topical ophthalmic or systemic treatment with corn oil vehicle, estradiol, or testosterone for 6 weeks. Schirmer test (SIT), assessment of tear film breakup time (BUT), corneal fluorescein staining, and measurement of estradiol and testosterone levels were performed before OVX and 1, 2, 3, 4, and 5 months after OVX, as well as after 6 weeks of treatment. Lacrimal glands were assessed for MMP-2 mRNA and protein expression. The mean (SD) tear film BUT decreased from 10.53 (0.79) to 9.98 (1.00) seconds (P < 0.01) in the first month after OVX, and the mean (SD) SIT result decreased by 50% from 7.32 (1.61) to 3.39 (1.15) mm (P < 0.01) in the third month after OVX. The mean (SD) corneal fluorescein staining score increased from 0.35 (0.11) to 6.02 (1.34) (P < 0.05) in the fourth month after OVX. The values increased or decreased in parallel with the time course (P < 0.01). In serum, ovariectomy resulted in a mean (SD) decline in estradiol levels from 44.38 (9.78) to 23.00 (3.78) pg/mL (P < 0.01), and the mean (SD) testosterone levels decreased from 2.42 (0.26) to 1.87 (0.15) ng/mL (P < 0.05). The mean (SD) estradiol level was elevated to 35.38 (3.34) pg/mL by systemic estradiol administration for 6 weeks, which also led to further mean (SD) decreases in tear film BUT from 5.28 (0.81) to 3.65 (0.55) seconds (P < 0.01) and in SIT result from 2.19 (1.01) to 1.47 (0.85) mm (P < 0.05), as well as a higher mean (SD) corneal fluorescein staining score from 7.39 (1.34) to 9.89 (1.27) (P < 0.05). However, the mean (SD) testosterone level was increased to 3.53 (0.67) ng/mL by systemic testosterone administration for 6 weeks. As a result, the mean (SD) tear film BUT increased from 5.08 (0.40) to 6.03 (1.48) seconds (P < 0.05), and the mean (SD) SIT result increased from 2.38 (1.20) to 3.66 (1.90) mm (P < 0.05). The mean (SD) corneal fluorescein staining score declined from 7.45 (0.73) to 4.56 (1.21) (P < 0.05). In the nontreated OVX group, the mean (SD) MMP-2 mRNA (0.66 [0.10]) and protein (0.55 [0.13]) expression in lacrimal glands was significantly increased compared with that in the sham-operated group (0.50 [0.09] and 0.40 [0.07], respectively) (P < 0.05). Systemic estradiol administration further increased the mean (SD) MMP-2 mRNA (0.83 [0.10]) and protein (0.69 [0.12]) expression (P < 0.05), while systemic testosterone administration decreased the mean (SD) MMP-2 mRNA (0.12 [0.04]) and protein (0.27 [0.07]) expression (P < 0.01). Topical ophthalmic administration of two sex hormones had no effect on the mean (SD) MMP-2 mRNA (0.59 [0.12] for estradiol and 0.57 [0.14] for testosterone) or protein (0.49 [0.11] for estradiol and 0.46 [0.13] for testosterone) expression (P > 0.05). Ovariectomy-induced ocular surface impairment may be associated with androgen deficiency. A pathogenetic role for estrogen in dry eye may involve upregulation of MMP-2 expression, while androgen suppresses MMP-2 expression.

Despite the widespread use of topical CsA to treat dry eye, we found that evidence on the effect of CsA on ocular discomfort and ocular surface and tear film parameters such as corneal fluorescein staining, Schirmer's test, and TBUT is inconsistent and sometimes may not be different from vehicle or artificial tears for the time periods reported in the trials. There may be an increase in non-serious, treatment-related adverse effects (particularly burning) in the CsA group. Topical CsA may increase the number of conjunctival goblet cells. However, current evidence does not support that improvements in conjunctival mucus production (through increased conjunctival goblet cells) translate to improved symptoms or ocular surface and tear film parameters. All published trials were short term and did not assess whether CsA has longer-term disease-modifying effects. Well-planned, long-term, large clinical trials are needed to better assess CsA on long-term dry eye-modifying effects. A core outcome set, which ideally includes both biomarkers and patient-reported outcomes in the field of dry eye, is needed.

Objective To investigate the clinical effect of subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with danhong iontophoresis in treatment of blepharospasm with dry eye. Methods The clinical data of 64 patients (75 eyes) with blepharospasm and dry eye treated in The Second People′s Hospital of Lianyungang were collected from September 2014 to June 2016. According to the digital table method, the patients were randomly divided into control group and treatment group. Among them, there were 30 cases (34 eyes) in the control group and 34 cases (41 eyes) in the treatment group. 30 cases (34 eyes) enrolled in the control group were treated with oral mecobalamin capsule and sodium hyaluronate eye drops. On the basis of the control group′s treatments, 34 cases (41 eyes) enrolled in the treatment group were treated by injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis. Before and after treatment, two groups of patients were examined in classification of blepharospasm, SchirmerⅠtest (SIt), breakup time (BUT), and corneal fluorescent staining, respectively. SIt wetted length, BUT, and corneal fluorescein staining scores were presented as mean ± standard deviation(±s), and compared by independent samples t-test between two groups, and compared by paired samples t-test before and after treatment. The intensity of blepharospasm was divided into four grades, and the results were compared by Kruskal-Wallis H rank sum test. The therapeutic effect of blepharospasm was expressed as the number of cases and percentage (%), and the total effective rate was compared by chi square test. Results Before the treatment, the results of SIt, BUT and corneal fluorescent staining in the control group were (2.43±1.17) mm/5 min, (2.67±1.03) s and (5.10±1.71) points; after treatment, they were (10.00±2.99) mm/5 min, (9.10±2.44) s and (1.67±1.15) points, respectively. The results of SIt, BUT and corneal fluorescent staining were compared in the control group before and after treatment, and the differences were statistically significant (t=9.12, 10.26, 5.48; P 0.05). However, comparing the results of SIt, BUT and corneal fluorescent staining between the treatment group and control group, after the treatment, and the differences were statistically significant (t=3.88, 5.00, 2.25; P 0.05). But after the treatment, there was statistical difference in the total effective rate which was 94.12% in the treatment group and 80.00% in the control group (χ2=6.94, P<0.05). Conclusion Subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis is efficient in the treatment of blepharospasm and dry eye. Key words: Blepharospasm; Dry eye; Compound anisodine; Iontophoresis

Objective To investigate the clinical effect ofQiju-Dihuang decoction combined with tears naturale（hypromellose 2910,dextran 70 and glycerol eye drops）on dry eye of liver and kidneyYin deficiency patterns.Methods Sixty patients with dry eye in Fangxian People’s Hospital and Fangxian Hospital of TCM from Jan. 2010 to Aug. 2013 were divided into a control group（30 patients）and a treatment group（30 patients） randomly according to registration order. The patients in the control group were treated with tears naturale, while patients in the treatment group were additionally treated withQiju-Dihuang decoction orally on the basis of the control group. Both groups were treated for 8 weeks. After treatment, the clinical symptoms and signs were compared and the changes of breakup time of tear film（BUT）, Schirmer test I（S1T）and corneal fluorescein staining（FL）score were measured in both groups.Results The total effective rates in the treatment group and in the control group were 73.33%（22/30）and 46.67%（14/30）, respectively. The difference was statistically significant（χ2=4.44,P〈0.05）. After treatment, the BUT, S1T and FL score of the treatment group and the control group was significantly improved than those before in both groups（t=4.200, 4.374, 9.098, 2.147, 6.627,P〈0.05 orP〈0.01）, and the degrees of BUT, S1T score increased and FL score decreased in the treatment group were superior to those in the control group（t=2.75, 2.43, 3.05,P〈0.05 orP〈0.01）. ConclusionsQiju-Dihuang decoction combined with tears naturale can obviously improve dry eye of liver and kidneyYin deficiency patterns, increase tear secretion, and reduce the damage of canthus and conjunctiva. Its curative effect was superior to simple tears naturale. Key words: Dry Eye Syndromes; Qiju-Dihuang decoction; Artificial tears; Clinical study

Objective To study the therapeutic effect of abacterial acupuncture needle probing for obstructive meibomain gland dysfunction (O-MGD) . Methods This was a prospective randomized, controlled trial. A total of 61 patients (122 eyes) with O-MGD were selected and were randomly divided into an observation group (62 eyes) and control group (60 eyes) . Patients in the observation group were treated with abacterial acupuncture needle probing with artificial tears, while patients in the control group were treated with meibomian gland massage combined with artificial tears. The tear break-up time (BUT) , Schirmer Ⅰ test (SⅠt) , corneal fluorescein staining (CFS) , ocular surface disease index (OSDI) and the meibomian gland score were measured for all patients before treatment and 2 and 4 weeks after treatment. Results Insignificant differences were observed between the groups for all clinical test indexes before treatment. The value of CFS and the meibomian gland score after treatment were significantly lower than those before treatment (F=118.1, 474.6, P<0.05) , while the value of BUT and SⅠt were significantly higher than those before treatment (F=67.8, 54.8, P<0.05) . At 2 and 4 weeks after treatment, the values of CFS, OSDI and the meibomian gland score in the observation group were significantly lower than those in the control group (F=58.5, 8.2, 206.8, P<0.05) , while the values of BUT and SⅠt in the observation group were higher than those in the control group (F=300.2, 8.7, P<0.05) . After 2 and 4 weeks of treatment, the overall effective rates in the observation group were 98.4% and 95.2%, which were statistically significant compared to 25.0% and 21.7% in the control group (Z=7.73, 7.76, P<0.01) . Conclusion Both abacterial acupuncture needle probing and meibomian gland massage combined with artificial tears have effects on O-MGD, while the abacterial acupuncture needle probing is more effective. Key words: Meibomain gland; Abacterial acupuncture needle; Probing; Massage; Ophthalmic solutions