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长期使用硅水凝胶对有无睑板腺功能障碍患者眼表炎症和泪液功能的评估

Evaluation of Long-Term Silicone Hydrogel Use on Ocular Surface Inflammation and Tear Function in Patients With and Without Meibomian Gland Dysfunction.

作者信息

Yucekul Burcu, Mocan Mehmet C, Kocabeyoglu Sibel, Tan Cagman, Irkec Murat

机构信息

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.

出版信息

Eye Contact Lens. 2019 Jan;45(1):61-66. doi: 10.1097/ICL.0000000000000526.

Abstract

OBJECTIVES

To determine whether silicone hydrogel (SH) contact lens (CL) use, with or without meibomian gland dysfunction (MGD), promotes ocular surface inflammation.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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