Píšová A, Chovanec M, Betka J, Ferrová K, Česká Burdová M, Odehnal M, Dotřelová D, Mahelková G
Cesk Slov Oftalmol. 2016 Fall;72(5):172-176.
Lagophthalmos can be characterized as the dysfunction of the eye aperture and in some cases even by the disruption of tear production. Dry eye syndrome can consequently develop. Instability of the tear film, hyperosmolarity and inflammatory reaction are considered as the key mechanisms of dry eye syndrome. In our report we monitored the tear osmolarity of patients with postsurgical unilateral lagophthalmos. Results were compared with tear osmolarity of the non-lagophthalmic eyes.
We examined 10 patients (6 women, 4 men) with postsurgical facial nerve palsy and lagophthalmos complicating management of either cerebellopontine (8 patients) or salivary gland tumors (2 patients). Only patients without severe corneal defects enrolled the study. The tear osmolarity was measured in lower tear meniscus by TearLab Osmolarity System device. The lagophthalmic eye was always examined first. The results are presented as mean plus/minus the standard deviation. The paired t-test was used for statistical data processing. The p-value 0,05 was considered as statistically significant.
The mean tear osmolarity of the lagophthalmic eyes was 296 ± 15,0 mosmol/l (275-315 mosmol/l). In case of healthy eyes the mean osmolarity was 310 ± 12 mosmol/l (292-336 mosmol/l). The tear osmolarity in case of lagophthalmos was significantly lower than in the healthy eyes (p = 0,05).
In contrary to the studies demonstrating higher tear osmolarity under the scenario of dry eye syndrome, we found lower tear osmolarity in the lagophthalmic eyes than in the healthy eyes. The possible reason could be the changes in tear dynamics of the lagophthalmic eye due to disturbance of eye lid function. Our results also stress the need of evaluation of the actual tear osmolarity in the view of complex clinical eye findings. The place of tear collection should also be considered.Key words: lagophthalmos, dry eye syndrom, tear osmolarity.
兔眼症可表现为眼裂功能障碍，在某些情况下甚至会导致泪液分泌中断。进而可能引发干眼症。泪膜不稳定、高渗状态及炎症反应被视为干眼症的关键发病机制。在本报告中，我们监测了单侧手术性兔眼症患者的泪液渗透压，并将结果与健侧眼的泪液渗透压进行了比较。
我们检查了10例（6例女性，4例男性）因手术导致面神经麻痹并伴有兔眼症的患者，这些患者的兔眼症是由桥小脑角区病变（8例）或涎腺肿瘤（2例）的治疗引起的。仅纳入无严重角膜缺损的患者进行研究。使用TearLab渗透压系统设备测量下泪弯月面的泪液渗透压。总是先检查兔眼侧。结果以平均值加减标准差表示。采用配对t检验进行统计数据处理。p值<0.05被视为具有统计学意义。
兔眼侧的平均泪液渗透压为296±15.0毫摩尔/升（275 - 315毫摩尔/升）。健侧眼的平均渗透压为310±12毫摩尔/升（292 - 336毫摩尔/升）。兔眼症患者的泪液渗透压显著低于健侧眼（p = 0.05）。
与显示干眼症情况下泪液渗透压升高的研究相反，我们发现兔眼侧的泪液渗透压低于健侧眼。可能的原因是眼睑功能紊乱导致兔眼侧泪液动力学发生改变。我们的结果还强调，鉴于复杂的临床眼部表现，需要评估实际的泪液渗透压。同时也应考虑泪液采集的部位。关键词：兔眼症；干眼症；泪液渗透压
