Kim Jin Sun, Lee Hun, Choi Seonghee, Kim Eung Kweon, Seo Kyoung Yul, Kim Tae-Im
a Department of Ophthalmology , The Institute of Vision Research, Yonsei University College of Medicine , Seoul , South Korea.
b Department of Ophthalmology , International St. Mary's Hospital, Catholic Kwandong University College of Medicine , Incheon , South Korea.
Semin Ophthalmol. 2018;33(2):231-236. doi: 10.1080/08820538.2016.1208764. Epub 2016 Sep 14.
To evaluate changes in the tear film lipid layer thickness (LLT) after cataract surgery and the effects of cataract surgery on dry eye syndrome (DES) and meibomian gland dysfunction (MGD).
LLT measurements obtained using the LipiView interferometer, tear break-up time (TBUT) measurements, Schirmer's tests, Oxford staining scores, lid margin and meibomian gland findings, and the Ocular Surface Disease Index (OSDI) questionnaire scores were evaluated before and one and three months after cataract surgery.
Forty-three eyes (43 patients) were included. LLT was significantly thinner one month after surgery than at baseline (P = 0.004). TBUT was significantly shorter at both one (P < 0.001) and three (P < 0.001) months after surgery than at baseline. OSDI scores were significantly higher (P < 0.001) and the meibum quality was significantly poorer (P = 0.001) at one month after surgery than at baseline. TBUT was significantly and positively correlated with LLT (r = 0.29, P < 0.001), while the OSDI (r = -0.38, P < 0.001) and Oxford staining (r = -0.30, P = 0.001) scores and the meibum quality (r = -0.21, P = 0.01) were significantly and negatively correlated with LLT.
The tear film LLT was significantly thinner and DES and MGD parameters showed deterioration after cataract surgery. In addition, LLT was significantly correlated with DES and MGD parameters. These results suggest that clinicians should consider the tear film lipid layer while managing the exacerbation of DES after cataract surgery.
评估白内障手术后泪膜脂质层厚度(LLT)的变化以及白内障手术对干眼综合征(DES)和睑板腺功能障碍(MGD)的影响。
使用LipiView干涉仪测量LLT、测量泪膜破裂时间(TBUT)、进行Schirmer试验、牛津染色评分、睑缘和睑板腺检查,以及在白内障手术前、术后1个月和3个月评估眼表疾病指数(OSDI)问卷评分。
纳入43只眼(43例患者)。术后1个月LLT明显比基线时更薄(P = 0.004)。术后1个月(P < 0.001)和3个月(P < 0.001)时TBUT均明显比基线时更短。术后1个月时OSDI评分明显更高(P < 0.001),睑脂质量明显更差(P = 0.001)。TBUT与LLT显著正相关(r = 0.29,P < 0.001),而OSDI(r = -0.38,P < 0.001)、牛津染色(r = -0.30,P = 0.001)评分以及睑脂质量(r = -0.21,P = 0.01)与LLT显著负相关。
白内障手术后泪膜LLT明显更薄,DES和MGD参数显示恶化。此外,LLT与DES和MGD参数显著相关。这些结果表明,临床医生在处理白内障手术后DES加重时应考虑泪膜脂质层。