School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China.
Cornea. 2012 Sep;31(9):1014-22. doi: 10.1097/ICO.0b013e31823f8d9e.
To investigate by ultrahigh resolution optical coherence tomography the effect of punctal occlusion on tear menisci in symptomatic and asymptomatic contact lens wearers.
Symptomatic subjects with self-reported dry eyes (n = 20) and asymptomatic subjects (n = 20) were recruited. For each subject, 1 eye was randomly chosen for both upper and lower punctal occlusion with collagen plugs. Ultrahigh resolution optical coherence tomography imaged both upper and lower tear menisci before punctal occlusion, and 1, 4, 7, and 10 days afterward. Comfort scoring, noninvasive tear break-up time, tear break-up time, and Schirmer test with anesthesia were also performed.
Tear meniscus variables in the symptomatic group were lower than those in the asymptomatic group (P < 0.05) at all time points except for day 4. In the symptomatic group, the tear menisci were increased up to day 4 after punctal occlusion (P < 0.05). The increase was present only on day 1 in the asymptomatic group. Improvement of comfort scores and noninvasive tear break-up time occurred in both groups after occlusion (P < 0.05). The comfort scores were linearly correlated with the tear volumes after punctal occlusion, with higher correlation coefficients in the symptomatic group.
Punctal occlusion transiently increased tear menisci in symptomatic and asymptomatic lens wearers, with a longer duration in the symptomatic group. For both symptomatic and asymptomatic lens wearers, the increased meniscus volume was associated with improved ocular comfort.
通过超高分辨率光相干断层扫描技术研究泪膜半月板在有症状和无症状接触镜佩戴者中，泪点阻塞对其的影响。
招募了有自我报告干眼症症状的患者（有症状组，n=20）和无症状患者（无症状组，n=20）。每只眼随机选择上、下泪点进行胶原塞阻塞。在阻塞前、阻塞后 1、4、7 和 10 天，使用超高分辨率光相干断层扫描技术对上下泪膜半月板进行成像。同时还进行了舒适度评分、非侵入性泪膜破裂时间、泪膜破裂时间和麻醉下 Schirmer 测试。
在所有时间点，除了第 4 天外，有症状组的泪膜半月板变量均低于无症状组（P<0.05）。在有症状组中，泪膜半月板在泪点阻塞后第 4 天增加（P<0.05）。在无症状组中，这种增加仅出现在第 1 天。两组在阻塞后舒适度评分和非侵入性泪膜破裂时间均得到改善（P<0.05）。在阻塞后，舒适度评分与泪液量呈线性相关，在有症状组中相关性更高。
泪点阻塞可短暂增加有症状和无症状接触镜佩戴者的泪膜半月板，在有症状组中持续时间更长。对于有症状和无症状的接触镜佩戴者，增加的半月板体积与改善的眼部舒适度相关。
