El Ameen A, Majzoub S, Vandermeer G, Pisella P-J
Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
J Fr Ophtalmol. 2018 Jun;41(6):526-535. doi: 10.1016/j.jfo.2017.11.021. Epub 2018 Jun 7.
To evaluate the influence of cataract surgery on meibomian gland dysfunction, in particular on postoperative functional symptoms.
Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break up time [TBUT], corneal staining, meibomian gland expressibility test) and a paraclinical evaluation (loss of Meibomius glands [LMG] measured using ImageJ on meibography, conjunctival redness and non-invasive tear break up time [NIK-BUT]) were performed preoperatively and at 1 month and 3 months after phacoemulsification.
TBUT and meibomian gland expressibility were worsened at 1 month and 3 months postoperatively (P<0.05). LMG was significantly more important for the upper eyelid and the mean at 1 month (33.1±15.2 P=0.02; 28.5±15.6 P=0.025, respectively) and 3 months postoperatively (36.5±17.4 P=0.0005; 31.2±17.4 P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between LMG on the upper eyelid preoperatively and the OSDI score at 1 month postoperatively (R=0.37; P=0.05).
The meibomian gland loss in the upper eyelid is associated with an increased postoperative ocular discomfort score. Alterations in the meibomian gland expressibility and TBUT persist for up to 3 months postoperatively suggesting a direct role of cataract surgery by an obstructive mechanism.
评估白内障手术对睑板腺功能障碍的影响,尤其是对术后功能症状的影响。
本研究纳入了30例行白内障手术的患者。术前以及超声乳化术后1个月和3个月进行了临床检查(眼表疾病指数问卷、泪膜破裂时间[TBUT]测量、角膜染色、睑板腺可挤压性测试)和辅助检查(使用ImageJ软件在睑板腺造影上测量睑板腺缺失[LMG]、结膜充血和非侵入性泪膜破裂时间[NIK-BUT])。
术后1个月和3个月时,TBUT和睑板腺可挤压性变差(P<0.05)。上睑的LMG在术后1个月(分别为33.1±15.2,P=0.02;28.5±15.6,P=0.025)和3个月(分别为36.5±17.4,P=0.0005;31.2±17.4,P=0.0002)时比术前值(分别为29.4±15.3;26±15)明显更严重。术前上睑的LMG与术后1个月的眼表疾病指数评分之间存在显著相关性(R=0.37;P=0.05)。
上睑睑板腺缺失与术后眼部不适评分增加有关。睑板腺可挤压性和TBUT的改变在术后持续长达3个月,提示白内障手术通过阻塞机制起直接作用。