From the University Hospital of Brest, Brest, France.
From the University Hospital of Brest, Brest, France.
J Cataract Refract Surg. 2018 Feb;44(2):144-148. doi: 10.1016/j.jcrs.2017.10.050.
To determine the incidence of meibomian gland dysfunction and quantify subjective dry-eye symptoms in cataract surgery candidates.
Brest University Hospital, Brest, France.
Prospective case series.
Patients having cataract surgery between November 2015 and June 2016 completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Lipid layer thickness and partial blink rate measurements as well as gland structure assessment were performed using the Lipiview Ocular Surface Interferometer. A slitlamp examination determined tear breakup time; the quantity and quality of the meibomian gland secretion were determined using the Meibomian Gland Evaluator.
The study comprised 342 eyes of 180 patients. The mean lipid layer thickness was 72.5 nm ± 19.91 (SD). In patients with a SPEED score lower than 8, the mean lipid layer thickness was 77.5 ± 19.48 nm. In patients with a SPEED score of 8 or higher, the mean lipid layer thickness was 58.5 ± 19.58 nm. The difference in lipid layer thickness between SPEED score groups was statistically significant (P < .05). Fifty-two percent of patients had meibomian gland dysfunction, and 56% had meibomian gland atrophy equal to or more than Arita grade 1. Meibomian gland function correlated significantly with lipid layer thickness, symptoms, age, and gland atrophy (P < .05).
The incidence of meibomian gland dysfunction was high in patients presenting for cataract surgery. Fifty percent of patients with meibomian gland dysfunction were asymptomatic. Correct criteria and meibomian function and structure assessment are critical to diagnosis. Comprehensive preoperative testing should routinely include evaluation of meibomian function.
确定睑板腺功能障碍的发生率，并量化白内障手术患者的主观干眼症状。
法国布雷斯特大学医院。
前瞻性病例系列。
2015 年 11 月至 2016 年 6 月期间接受白内障手术的患者完成了标准患者眼干燥评估（SPEED）问卷。使用 Lipiview 眼表面干涉仪测量脂质层厚度和部分眨眼率，并评估腺体结构。裂隙灯检查确定泪膜破裂时间；使用 Meibomian 腺评估器确定睑板腺分泌物的数量和质量。
该研究包括 180 名患者的 342 只眼。平均脂质层厚度为 72.5 ± 19.91nm（标准差）。在 SPEED 评分低于 8 的患者中，平均脂质层厚度为 77.5 ± 19.48nm。在 SPEED 评分为 8 或更高的患者中，平均脂质层厚度为 58.5 ± 19.58nm。脂质层厚度在 SPEED 评分组之间的差异具有统计学意义（P < 0.05）。52%的患者存在睑板腺功能障碍，56%的患者存在睑板腺萎缩等于或大于 Arita 1 级。睑板腺功能与脂质层厚度、症状、年龄和腺体萎缩显著相关（P < 0.05）。
在接受白内障手术的患者中，睑板腺功能障碍的发生率较高。50%的睑板腺功能障碍患者无症状。正确的标准和睑板腺功能及结构评估对诊断至关重要。综合术前检查应常规包括睑板腺功能评估。
