Goto Eiki, Endo Koji, Suzuki Atsushi, Fujikura Yoshiaki, Matsumoto Yukihiro, Tsubota Kazuo
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Invest Ophthalmol Vis Sci. 2003 Feb;44(2):533-9. doi: 10.1167/iovs.02-0170.
To test a newly developed tear evaporimetry system that detects real-time changes in tear evaporation rates and shows the tear film stability in patients with obstructive meibomian gland dysfunction (MGD).
A ventilated chamber system with high-sensitivity microbalance sensor was used to evaluate tear evaporation. Tear evaporation rates and dynamic changes in them in response to blinking ("flip heights") were measured. Both were compared in 38 eyes of 22 normal subjects and 32 eyes of 21 patients with obstructive MGD, in a prospective case-control study. The relationship between tear evaporation rates and flip heights to meibomian gland orifice obstruction was also analyzed.
Changes in tear evaporation rates produced by blinking were detected. The tear evaporation rates in the patients' group were 5.8 +/- 2.7(10(-7)) g/cm(2) per second, significantly higher than in normal subjects (4.1 +/- 1.4[10(-7)] g/cm(2) per second; P = 0.0008). The flip heights in the obstructive MGD group were 0.58 +/- 0.33(10(-7)) g/cm(2) per second, significantly higher than in normal subjects (0.39 +/- 0.27[10(-7)] g/cm(2) per second, P = 0.02). The correlations between both tear evaporation rates and flip heights to the meibomian gland orifice obstruction score were statistically significant (P < 0.0001 and P = 0.004, respectively).
This new system was helpful in differentiating MGD patients from normal subjects. These significantly higher evaporation rates and higher flip heights reflect the unstable tear evaporation and may well indicate unstable tear film in patients with obstructive MGD with abnormal evaporative tear loss.
测试一种新开发的泪液蒸发测定系统，该系统可检测泪液蒸发速率的实时变化，并显示阻塞性睑板腺功能障碍（MGD）患者的泪膜稳定性。
使用带有高灵敏度微量天平传感器的通风室系统评估泪液蒸发。测量泪液蒸发速率及其对眨眼的动态变化（“翻转高度”）。在一项前瞻性病例对照研究中，对22名正常受试者的38只眼和21名阻塞性MGD患者的32只眼进行了比较。还分析了泪液蒸发速率和翻转高度与睑板腺开口阻塞之间的关系。
检测到眨眼引起的泪液蒸发速率变化。患者组的泪液蒸发速率为每秒5.8±2.7（10⁻⁷）g/cm²，显著高于正常受试者（每秒4.1±1.4[10⁻⁷]g/cm²；P = 0.0008）。阻塞性MGD组的翻转高度为每秒0.58±0.33（10⁻⁷）g/cm²，显著高于正常受试者（每秒0.39±0.27[10⁻⁷]g/cm²，P = 0.02）。泪液蒸发速率和翻转高度与睑板腺开口阻塞评分之间的相关性均具有统计学意义（分别为P < 0.0001和P = 0.004）。
这种新系统有助于区分MGD患者和正常受试者。这些显著更高的蒸发速率和更高的翻转高度反映了泪液蒸发不稳定，很可能表明阻塞性MGD患者伴有异常蒸发性泪液流失时泪膜不稳定。
