目的：研究老年睑板腺功能障碍(MGD)蠕形螨感染率及茶树精油联合氟米龙的疗效。

方法：回顾性病例对照研究。选择2017-09/2018-03在宁波市眼科医院门诊就诊的老年MGD患者59例118眼。将睫毛蠕形螨镜检为阳性的38例患者76眼进行症状评分、蠕形螨数量、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、Schirmer I试验(SIaT)等检查，并按不同治疗方法分成3组，A组使用0.02%氟米龙滴眼液滴眼24眼； B组使用茶树精油(TTO)湿巾敷眼26眼； C组用0.02%氟米龙滴眼液滴眼联合TTO湿巾敷眼26眼，随访4wk。

结果：118眼中76眼(64.4%)睫毛蠕形螨镜检为阳性。睫毛蠕形螨阳性的三组患者治疗后的主观症状评分均较治疗前有改善(P<0.05)。治疗后A组蠕形螨数量较治疗前无显著差异(P=0.11)； B、C组较治疗前明显减少(均P<0.01)。三组患者BUT治疗前后比较，A组BUT无显著差异(P=0.22)； B、C组BUT明显延长(均P<0.05)。治疗后C组的BUT较A、B组明显延长(均P<0.05)。三组患者治疗前后的FL评分均较治疗前明显改善(P<0.05)。

结论：老年MGD患者睫毛蠕形螨感染率较高，睑板腺热疏通后TTO湿巾联合0.02%氟米龙滴眼液能有效驱螨、缓解MGD患者局部症状。

METHODS: In this retrospective clinical control study, a total of 59 elderly patients(118 eyes)with MGD were included in Ningbo Eye Hospital during September 2017 to March 2018. Symptoms score, Demodex number, Tarsal gland morphology, tear break-up time(BUT), Fluorescein staining(FL)and Schirmer test(SIaT)were evaluated in 38 patients(76 eyes)with positive eyelash examination. The patients were divided into three groups and treated with different methods after blepharoplasty-Groups A(24 eyes), B(26 eyes)and C(26 eyes)were treated with 0.02% fluorometholone eye drops; tea tree essential oil wipes; and 0.02% fluorometholone eye drops combined with tea tree essential oil wipes, respectively. The follow-up was 4wk.

RESULTS: The eyelash Demodex was detected in 76 eyes(64.4%). The scores of subjective symptoms in the three groups were improved after treatment(P<0.05). There was no statistical difference in the number of Demodex before and after treatment in group A(P=0.11); there were statistical differences in groups B and C(P<0.01). There was no significant difference between group A(P=0.22), groups B and C had significant difference(P<0.05)in BUT before and after treatment. BUT in group C was longer than that in groups A and B, and the difference was statistically significant(P<0.05)after treatment. FL scores of the three groups before and after treatment were significantly different(P<0.05).

CONCLUSION: The infection rate of Demodex mites in eyelashes of elderly patients with MGD is higher. Tea tree essential oil wipes combined with 0.02% fluorometholone eye drops can effectively repel mites, improvement of lipid secretion by meibomian gland, and relieve local symptoms of MGD.