Department of Ophthalmology and Optometry, EENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
Ophthalmic Res. 2021;64(2):224-229. doi: 10.1159/000509060. Epub 2020 Jun 2.
The aim of this study was to determine the prevalence of preoperative dry eye disease and evaluate tear film function in refractive surgery candidates in China.
In this prospective noninterventional cross-sectional study, refractive surgical candidates from 13 preselected eye hospitals in China were recruited from July 2015 to February 2016. Patient histories, subjective symptoms, tear film breakup time (TBUT), ocular surface fluorescein staining, and Schirmer I tests (SIT), were assessed to conduct subgroup analysis.
A total of 1,849 patients were recruited, 41.4% were diagnosed with dry eye disease (766/1,849) and 44.9% (830/1,849) of subjects had a positive history of contact lens (CL) wear. The overall mean TBUT and SIT values were 7.3 ± 3.7 s and 15.2 ± 8.8 mm, respectively. The total prevalence of ocular surface fluorescein staining was 23.46% (422/1,849); 44.62% of patients had TBUT <5 s and 23.20% of patients had SIT <5 mm. CL wearers were observed to have a higher prevalence of dry eye than non-CL wearers (54.1 vs. 35.2%, OR = 2.17, 95% CI: 1.77-2.65).
In this study, the most common abnormal finding in dry eye disease was tear film instability. A high proportion of refractive surgery candidates have preexisting dry eye disease and a history of CL wear prior to surgery. Careful attention should be given to the evaluation of preoperative dry eye in refractive surgery candidates.
本研究旨在确定中国屈光手术患者术前干眼的患病率，并评估泪膜功能。
在这项前瞻性、非干预性的横断面研究中，于 2015 年 7 月至 2016 年 2 月，从中国 13 家选定的眼科医院招募了屈光手术候选者。评估患者病史、主观症状、泪膜破裂时间（TBUT）、眼表面荧光素染色和泪液分泌试验（SIT），进行亚组分析。
共招募了 1849 名患者，其中 41.4%（766/1849）被诊断为干眼，44.9%（830/1849）的患者有隐形眼镜（CL）佩戴史。总的平均 TBUT 和 SIT 值分别为 7.3±3.7 s 和 15.2±8.8 mm。总的眼表面荧光素染色阳性率为 23.46%（422/1849）；44.62%的患者 TBUT<5 s，23.20%的患者 SIT<5 mm。CL 佩戴者的干眼患病率高于非 CL 佩戴者（54.1%比 35.2%，OR=2.17，95%CI：1.77-2.65）。
在这项研究中，干眼最常见的异常发现是泪膜不稳定。相当一部分屈光手术候选者在手术前就患有干眼和隐形眼镜佩戴史。在屈光手术候选者中，应仔细关注术前干眼的评估。
