School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
Cont Lens Anterior Eye. 2018 Apr;41(2):144-153. doi: 10.1016/j.clae.2017.10.004. Epub 2017 Oct 18.
To investigate characteristics of the eyelid margins, meibomian glands and the tear film of contact lens wearers, and to determine whether these characteristics were related to symptoms of contact lens discomfort.
A cross sectional study was performed on thirty existing daily wear soft contact lens wearers (6 male; 24 female) with median age of 23 years (range 18-41). Eyelid signs and tear film characteristics were evaluated during a single visit and subjects completed the contact lens and dry eye questionnaire (CLDEQ-8) to evaluate ocular discomfort.
Based on the CLDEQ-8 responses, subjects were classified as symptomatic (n = 17) or asymptomatic (n = 13). Grades of foam at meibomian gland orifices (3 ± 1), expressibility (2 ± 1) and quality of secretions (2 ± 1), tear evaporation rate with (112 ± 54 g/m/h) or without (88 ± 45 g/m/h) contact lens wear, fluorescein tear breakup time (8 ± 2 seconds) and tear lipid layer thickness (45 ± 17 nm) were significantly associated with symptoms of discomfort in symptomatic lens wearers only (r > 0.45; p value < 0.05). Upper lid-wiper epitheliopathy, meibomian gland acini reflectivity and tear meniscus height showed significant correlations with comfort scores in both symptomatic and asymptomatic contact lens wearers (p < 0.05). A greater number of Demodex mites was also observed in the upper eyelid of symptomatic lens wearers (2 ± 1) compared to asymptomatic lens wearers (0 ± 0; p value = 0.042).
Morphological irregularities of the meibomian glands and alterations to tear film secretions that affect tear evaporative dynamics were associated with symptoms of discomfort amongst the symptomatic lens wearers.
研究接触镜佩戴者的眼睑边缘、睑板腺和泪膜特征，并确定这些特征是否与接触镜不适症状有关。
对 30 名现有日戴软性隐形眼镜佩戴者（6 名男性；24 名女性）进行横断面研究，中位年龄 23 岁（范围 18-41 岁）。在单次就诊时评估眼睑体征和泪膜特征，受试者完成隐形眼镜和干眼问卷（CLDEQ-8）以评估眼部不适。
根据 CLDEQ-8 的回答，受试者被分为有症状（n=17）或无症状（n=13）。睑板腺口泡沫等级（3±1）、可挤出性（2±1）和分泌物质量（2±1）、戴或不戴隐形眼镜时的泪液蒸发率（分别为 112±54g/m/h 和 88±45g/m/h）、泪膜破裂时间（8±2 秒）和泪液脂质层厚度（45±17nm）在有症状的隐形眼镜佩戴者中与不适症状显著相关（r>0.45；p 值<0.05）。上睑刮擦上皮病、睑板腺腺泡反射率和泪膜新月形高度与有症状和无症状隐形眼镜佩戴者的舒适度评分均有显著相关性（p<0.05）。在有症状的隐形眼镜佩戴者的上眼睑中还观察到更多的蠕形螨（2±1），而无症状的隐形眼镜佩戴者中为 0±0（p 值=0.042）。
睑板腺形态不规则和影响泪液蒸发动力学的泪液分泌改变与有症状的隐形眼镜佩戴者的不适症状有关。
