Yucekul Burcu, Mocan Mehmet C, Kocabeyoglu Sibel, Tan Cagman, Irkec Murat
Department of Ophthalmology, (B.Y., M.C.M., S.K., M.I.), Hacettepe University, Ankara, Turkey; and Department of Pediatrics (Ç.T.), Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Eye Contact Lens. 2019 Jan;45(1):61-66. doi: 10.1097/ICL.0000000000000526.
To determine whether silicone hydrogel (SH) contact lens (CL) use, with or without meibomian gland dysfunction (MGD), promotes ocular surface inflammation.
Subjects wearing SH-CL for at least 6 months who also had coexisting MGD (group 1, n=20), SH-CL users who did not have MGD (group 2, n=20), patients who had MGD but did not use CL (group 3, n=20), and healthy CL-naive individuals with no known systemic or ocular diseases (group 4, n=20) were included in this cross-sectional, single-center study. All subjects underwent tear function tests consisting of tear break-up time (tBUT), ocular surface staining, Schirmer test, and the Ocular Surface Disease Index (OSDI) questionnaire, as well as determination of tear IL-1RA, IL-1β, IL-2, IL-2R, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, IFN-α, IFN-γ, TNF-α, granulocyte-macrophage colony-stimulating factor, IP-10, monokine induced by gamma interferon, RANTES, eotaxin, MIP-1α, MIP-1β, and MCP-1 levels using Luminex multicytokine immunobead assay. Intergroup comparisons were made using one-way analysis of variance or Kruskal-Wallis test.
The tBUT was lower (P=0.048) and ocular surface staining (P=0.032) as well as OSDI scores (P=0.001) were higher in group 1 but not in groups 2 or 3 when compared with those in the control group. Tear cytokine levels were similar across all groups. None of the tear cytokine levels were elevated in CL wearers (groups 1 and 2) or those with MGD (groups 1 and 3) as compared to those in control subjects.
Silicone hydrogel contact lens use with concomitant MGD is not associated with cytokine-driven ocular surface inflammation but may impact tear function leading to dry eye symptoms.
确定使用含硅水凝胶(SH)隐形眼镜(CL),无论有无睑板腺功能障碍(MGD),是否会促进眼表炎症。
本横断面单中心研究纳入了至少佩戴SH - CL 6个月且同时患有MGD的受试者(第1组,n = 20)、无MGD的SH - CL使用者(第2组,n = 20)、患有MGD但未使用CL的患者(第3组,n = 20)以及无已知全身性或眼部疾病的健康未佩戴CL个体(第4组,n = 20)。所有受试者均接受了泪液功能测试,包括泪膜破裂时间(tBUT)、眼表染色、泪液分泌试验以及眼表疾病指数(OSDI)问卷,还使用Luminex多细胞因子免疫磁珠测定法测定了泪液中白细胞介素-1受体拮抗剂(IL - 1RA)、白细胞介素-1β(IL - 1β)、白细胞介素-2(IL - 2)、白细胞介素-2受体(IL - 2R)、白细胞介素-4(IL - 4)、白细胞介素-5(IL - 5)、白细胞介素-6(IL - 6)、白细胞介素-7(IL - 7)、白细胞介素-8(IL - 8)、白细胞介素-10(IL - 10)、白细胞介素-12(IL - 12)、白细胞介素-13(IL - 13)、白细胞介素-15(IL - 15)、白细胞介素-17(IL - 17)、干扰素-α(IFN - α)、干扰素-γ(IFN - γ)、肿瘤坏死因子-α(TNF - α)、粒细胞-巨噬细胞集落刺激因子、IP - 10、γ干扰素诱导的单核因子、调节激活正常T细胞表达和分泌因子(RANTES)、嗜酸性粒细胞趋化因子、巨噬细胞炎性蛋白-1α(MIP - 1α)、巨噬细胞炎性蛋白-1β(MIP - 1β)和单核细胞趋化蛋白-1(MCP - 1)的水平。采用单因素方差分析或Kruskal - Wallis检验进行组间比较。
与对照组相比,第1组的tBUT较低(P = 0.048),眼表染色(P = 0.032)以及OSDI评分(P = 0.001)较高,但第2组和第3组无此情况。所有组的泪液细胞因子水平相似。与对照组相比,隐形眼镜佩戴者(第1组和第2组)或MGD患者(第1组和第3组)的泪液细胞因子水平均未升高。
使用含硅水凝胶隐形眼镜并伴有MGD与细胞因子驱动的眼表炎症无关,但可能影响泪液功能,导致干眼症状。