隐形眼镜佩戴对睑板擦除区细胞形态的影响。

The Effect of Contact Lens Wear on the Cellular Morphology of the Lid Wiper Area.

作者信息

Alghamdi Waleed M, Markoulli Maria, Papas Eric B

机构信息

Department of Optometry, College of Applied Medical Science, Qassim University, Qassim, Saudi Arabia.

School of Optometry & Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Optom Vis Sci. 2018 Jun;95(6):491-497. doi: 10.1097/OPX.0000000000001224.

DOI:10.1097/OPX.0000000000001224

PMID:29787485

Abstract

SIGNIFICANCE

This cross-sectional study presented a link between contact lens wear and changes on the cellular morphology characteristics of the lid wiper (LW) epithelium, which was not visible by LW staining.

PURPOSE

The aim of this study was to establish if the duration of contact lens (CL) wear affects the cellular morphology of the LW epithelium.

METHODS

This was a cross-sectional study of 100 individuals with different exposures to CL wear: short, moderate, and long experience of CL wear; previous CL wearers; and nonwearers (NWs) as controls. Impression cytology samples were collected from the central upper lid margin (LW area). After fixing, samples were stained with periodic acid-Schiff and haematoxylin for cell morphology analysis and subsequently graded according to the Nelson 0- to 3-point scale. Lid wiper staining was assessed with the aid of lissamine green and graded using the Korb (0- to 3-point) scale. One-way Kruskal-Wallis analysis followed by the Dunn multiple-comparisons test was used for statistical comparison.

RESULTS

The Nelson grade for LW epithelium morphology was significantly different between groups (P = .003). Abnormal epithelial morphology as defined by grade 2 or 3 was evident in 66.7% of CL wearers with short experience and 76.5% of CL wearers with moderate experience. This was significantly higher than NWs of whom only 21.5% showed greater than grade 1 (P = .02 and .005, respectively). There was no significant difference between NWs and other groups. Lid wiper staining did not significantly differ between groups (P = .50) or correlate with the Nelson grade (Spearman r = 0.02, P = .08).

CONCLUSIONS

Metaplasia of the LW epithelium was significantly greater in the early to moderate stages of CL. This supports the view that mechanical irritation is responsible for LW changes in CL wear. Ceasing CL wear seems to lead to recovery. Lid wiper staining did not reflect the underlying morphological changes.

摘要

意义

这项横断面研究揭示了隐形眼镜佩戴与睑板腺擦拭缘（LW）上皮细胞形态特征变化之间的联系，而这种变化通过LW染色无法观察到。

目的

本研究的目的是确定隐形眼镜（CL）佩戴时长是否会影响LW上皮细胞的形态。

方法

这是一项横断面研究，研究对象为100名隐形眼镜佩戴经历不同的个体：短期、中期和长期佩戴CL者；既往CL佩戴者；以及作为对照的非佩戴者（NWs）。从中央上睑缘（LW区域）采集印片细胞学样本。固定后，样本用高碘酸-希夫试剂和苏木精染色以进行细胞形态分析，随后根据尼尔森0至3分制进行分级。借助丽丝胺绿评估LW染色情况，并使用科尔布（0至3分）量表进行分级。采用单向克鲁斯卡尔-沃利斯分析，随后进行邓恩多重比较检验进行统计学比较。

结果

LW上皮细胞形态的尼尔森分级在各组之间存在显著差异（P = 0.003）。短期佩戴CL者中66.7%以及中期佩戴CL者中76.5%出现了2级或3级所定义的异常上皮形态。这显著高于NWs，NWs中只有21.5%的人显示高于1级（分别为P = 0.02和0.005）。NWs与其他组之间没有显著差异。各组之间LW染色没有显著差异（P = 0.50），且与尼尔森分级无关（斯皮尔曼r = 0.02，P = 0.08）。