Contact Lens and Visual Optics Laboratory, School of Optometry, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld, 4059, Australia.
Contact Lens and Visual Optics Laboratory, School of Optometry, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld, 4059, Australia.
Cont Lens Anterior Eye. 2019 Jun;42(3):304-310. doi: 10.1016/j.clae.2018.09.003. Epub 2018 Sep 22.
To investigate the effect of multiple lid eversions on lid wiper epitheliopathy (LWE), along with the effect of cumulative lid exposure time and the patterns of associated staining.
The increase in area of lid wiper staining with lissamine green was compared by everting both the upper eyelids of each subject (i.e. contralateral design), with one eye being everted once for 45 s and the fellow eyelid everted three times, each time for 15 s. This pattern of contralateral eversion was repeated with a total of three eversions in one eye and nine eversions in the fellow eye, with each eye totalling 135 s cumulative exposure to eversion over about 9 min. The LWE area of staining was objectively quantified from slit lamp photography images captured at every lid eversion by 2 masked observers. Two-way repeated measures ANOVAs were used to determine the effect of number of lid eversions and cumulative exposure time on the amount of staining caused. Each image was also categorized into its primary LWE staining pattern, by a masked observer.
The multiple eversions condition caused significantly greater LWE than the single eversion condition (p < 0.001), while cumulative exposure time did not have a significant effect on LWE (p = 0.137). Classification of the primary staining patterns revealed that with more eyelid eversions there was a shift from mostly 'no staining' to minor patterns ('short horizontal bands' and 'vertical streaks') and then to more extensive patterns ('broad horizontal bands' and 'comb-shaped').
The number of eyelid eversions is a confounding factor that should be controlled when investigating LWE, in particular when considering the link with dry eye or contact lens discomfort. However the cumulative exposure time did not appear to influence the LWE magnitude.
研究多次眼睑外翻对眼睑清洁上皮病（LWE）的影响，以及累积眼睑暴露时间和相关染色模式的影响。
通过翻转每个受试者的上下眼睑（即对侧设计）来比较用丽丝胺绿增加的眼睑清洁染色面积，一只眼外翻 45 秒一次，另一只眼外翻三次，每次 15 秒。这种对侧外翻的模式在一只眼重复三次，在另一只眼重复九次，每只眼的总外翻累积暴露时间约为 9 分钟，共 135 秒。通过 2 名掩蔽观察者从裂隙灯摄影图像中客观地量化 LWE 染色区域。使用双向重复测量方差分析来确定外翻次数和累积暴露时间对染色量的影响。每个图像还由一名掩蔽观察者根据其主要的 LWE 染色模式进行分类。
多次外翻组引起的 LWE 明显大于单次外翻组（p<0.001），而累积暴露时间对 LWE 没有显著影响（p=0.137）。主要染色模式的分类表明，随着眼睑外翻次数的增加，主要为“无染色”的模式向轻度模式（“短水平带”和“垂直条纹”）转变，然后向更广泛的模式（“宽水平带”和“梳状”）转变。
眼睑外翻次数是研究 LWE 时需要控制的混杂因素，尤其是在考虑与干眼或隐形眼镜不适的关系时。然而，累积暴露时间似乎并不影响 LWE 的程度。
