[长期佩戴隐形眼镜对睑板腺形态的影响]

Tang Y, Wu Y, Rong B, Li H L, Yang S L, Yan X M

Department of Ophthalmology, Peking University First Hopstital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100034, China.

Zhonghua Yan Ke Za Zhi. 2016 Aug;52(8):604-9. doi: 10.3760/cma.j.issn.0412-4081.2016.08.009.

OBJECTIVE

To evaluate the effect of long-term contact lens (CL) wear on the morphology of meibomian glands (MGs) using meiboscore and digital analysis.

METHODS

Retrospective study. Sixty right eyes of sixty patients were involved in this study, and the data were analyzed retrospectively. According to the duration of CL wear, all patients were divided into three groups, nonwear group (n=21), short-term group (duration of CL wear ≤3 years, n=19) and long-term group (duration of CL wear>3 years, n=20). Digital images of MGs obtained by meibography were analyzed using Image J software, providing the area percentage of MGs loss. The meiboscores were also examined, and the data were analyzed using one-way ANOVA and Kruskal-Wallis test.

RESULTS

Ten out of 21 nonwearers were scored 0 point, and 11 were scored 1 point in the upper lid meiboscores, while 7 were scored 0 point, 9 were scored 1 point, and 5 were scored 2 points in the total meiboscores. Seven out of 19 short-term wearers were scored 0 point, 10 were scored 1 point, and 2 were scored 2 points in the upper lid meiboscores, while 5 were scored 0 point, 6 were scored 1 point, 6 were scored 2 points, and 2 were scored 3 points in the total meiboscores. Four out of 20 long-term wearers were scored 0 point, 7 were scored 1 point, and 9 were scored 2 points in the upper lid meiboscores, while 3 were scored 0 point, 4 were scored 1 point, 4 were scored 2 points, 4 were scored 3 points, 4 were scored 4 points, and 1 was scored 5 points in the total meiboscores. The meiboscores of the upper eyelid and total meiboscores among the three groups were significantly different (Hc=9.967, P=0.007; Hc=9.725, P=0.008). The meiboscores of the upper eyelid and total meiboscores were significantly higher in the long-term group compared to the nonwear group (Z=102.500, P=0.003, Z=100.500, P=0.003) and the short-term group (Z=120.500, P=0.050, Z=117.500, P=0.041). No significant difference was found between the short-term group and the nonwear group. The median of the MGs loss area percentage in the upper eyelid of the nonwear, short-term and long-term groups was 9.2%, 13.3% and 16.7%, respectively. The median of the total MGs loss area percentage in the nonwear, short-term and long-term groups were 6.6%, 8.8% and 13.0%, respectively. The above medians were significantly different among the three groups (Hc=6.390, P=0.041; Hc=7.019, P=0.030). They were significantly larger in the long-term wearers than the nonwearers (Z=120.500, P=0.019, Z=120.500, P=0.009). No significant difference was found between the short-term group and the nonwear group, or between the short-term group and the long-term group. No significant differences in the meiboscores or MGs loss area percentage in the lower eyelid were noticed among the three groups. The area under the curve of total area percentage of MGs loss in receiver operating characteristic analysis was 0.981 (P<0.001).

CONCLUSIONS

Long-term (more than 3 years) CL wear can cause MGs loss. Digital analysis is helpful in the morphologic evaluation of MGs. (Chin J Ophthalmol, 2016, 52: 604-609).

目的

采用睑板腺评分（meiboscore）和数字分析评估长期佩戴隐形眼镜（CL）对睑板腺（MGs）形态的影响。

方法

回顾性研究。本研究纳入60例患者的60只右眼，并对数据进行回顾性分析。根据佩戴CL的时长，将所有患者分为三组，即未佩戴组（n = 21）、短期佩戴组（CL佩戴时长≤3年，n = 19）和长期佩戴组（CL佩戴时长>3年，n = 20）。使用Image J软件分析睑板腺造影获得的MGs数字图像，得出MGs损失面积百分比。同时检查睑板腺评分，并采用单因素方差分析和Kruskal-Wallis检验对数据进行分析。

结果

21例未佩戴者中，10例上睑睑板腺评分为0分，11例为1分；总睑板腺评分中，7例为0分，9例为1分，5例为2分。19例短期佩戴者中，7例上睑睑板腺评分为0分，10例为1分，2例为2分；总睑板腺评分中，5例为0分，6例为1分，6例为2分，2例为3分。在20例长期佩戴者中，4例上睑睑板腺评分为0分，7例为1分，9例为2分；总睑板腺评分中，3例为0分，4例为1分，4例为2分，4例为3分，4例为4分，1例为作分。三组间上睑睑板腺评分和总睑板腺评分差异有统计学意义（Hc = 9.967，P = 0.007；Hc = 9.725，P = 0.008）。与未佩戴组相比，长期佩戴组的上睑睑板腺评分和总睑板腺评分显著更高（Z = 102.500，P = 0.003；Z = 100.500，P = 0.003）；与短期佩戴组相比亦显著更高（Z = 120.500，P = 0.050；Z = 117.500，P = 0.041）。短期佩戴组与未佩戴组之间差异无统计学意义。未佩戴组、短期佩戴组和长期佩戴组上睑MGs损失面积百分比的中位数分别为9.2%、13.3%和16.7%。未佩戴组、短期佩戴组和长期佩戴组MGs总损失面积百分比的中位数分别为6.6%、8.8%和13.0%。上述中位数在三组间差异有统计学意义（Hc = 6.390，P = 0.041；Hc = 7.019，P = 0.030）。长期佩戴者的上述中位数显著大于未佩戴者（Z = 120.500，P = 0.019；Z = 120.500，P = 0.009）。短期佩戴组与未佩戴组之间、短期佩戴组与长期佩戴组之间差异均无统计学意义。三组在下睑睑板腺评分或MGs损失面积百分比方面未发现显著差异。接受者操作特征分析中MGs损失总面积百分比曲线下面积为0.981（P<0.001）。