To investigate clinical treatment regimens for ocular lesions in patients with severe ocular rosacea.

A total of 28 patients (34 eyes) with severe rosacea complicated by blepharokeratoconjunctivitis were collected from outpatient department of the Affiliated Eye Hospital of Nanjing Medical University from December 1, 2019 to May 30, 2021. They were randomly divided into two groups: group A (13 cases, 16 eyes) topically treated with sodium hyaluronate 0.3% eye drops and levofloxacin 0.5% eye drops, and group B (15 cases, 18 eyes) topically treated with sodium hyaluronate 0.3% eye drops alone. Patients in both groups also received oral minocycline hydrochloride 100 mg every day for the first 2 weeks, and then 50 mg every day for the next 6 weeks. Meanwhile, all patients received same physical therapies such as meibomian gland massage, eyelid hot compresses and eyelid margin cleaning. LogMAR visual acuity, tear break-up time (BUT) , ocular surface disease index (OSDI) score, and meibomian gland function grading examination results in the two groups were recorded before and 8 weeks after treatment. Paired t test was used to compare within-group differences in the parameters before and after treatment, and two-independent-sample t test to compare intergroup differences after treatment.

After 8-week treatment, both group A and group B showed significantly increased LogMAR visual acuity (t = 3.10, 2.15, P = 0.007, 0.046, respectively) , improved BUT (t = 3.44, 2.85, P = 0.003, 0.011, respectively) , but significantly decreased OSDI scores (t = 7.12, 9.33, respectively, both P < 0.001) and meibomian gland function scores (t = 13.73, 16.82, respectively, both P < 0.001) compared with those before treatment. After treatment, no significant differences were observed in the LogMAR visual acuity (P = 0.721) , BUT (P = 0.189) , OSDI scores (P = 0.808) and meibomian gland function scores (P = 0.191) between the two groups. No adverse drug reactions occurred during the treatment. During the follow-up period (8 months or shorter) , no recurrence of ocular lesions was observed.

Without topical antibiotics, oral minocycline hydrochloride combined with topical sodium hyaluronate eye drops is still effective for the treatment and prevention of recurrence of ocular lesions in patients with severe ocular rosacea.

Rosacea; Eye diseases; Treatment outcome; Minocycline; Ocular rosacea; Levofloxacin eye drops; Sodium hyaluronate eye drops