Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China.
Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China,
Ophthalmic Res. 2021;64(3):356-362. doi: 10.1159/000511197. Epub 2020 Sep 22.
To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery.
This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively.
A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery.
ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.
评估植入性 Collamer 透镜 (ICL) 手术后干眼 (DE) 及相关睑板腺功能障碍参数。
这是一项前瞻性观察性病例系列研究。纳入无既往眼部疾病或眼科治疗史、接受 ICL 植入术的患者。术前及术后 1 个月和 3 个月时，对其进行眼表面疾病指数 (OSDI)、非侵入性泪膜破裂时间 (NIBUT)、睑板腺照相、睑缘裂隙灯检查、角膜荧光素染色 (CFS) 和 Schirmer 试验 I 检查。
共纳入 60 例患者的 117 只眼，其中 107 只眼完成了 3 个月的随访。术后 1 个月时 OSDI、睑缘异常和睑板腺 (MG) 分泌及睑脂质量评分显著升高，术后 3 个月时部分恢复，而 NIBUT 始终显著降低。有 DE 症状既往史（OSDI 评分≥12）的患者术后不仅 Schirmer 和 TBUT 值较低，而且 CFS、睑缘评分、MG 缺失、MG 分泌和睑脂质量评分也较对照组更高。术后 Schirmer 值较低、NIBUT 值较低和睑脂质量评分较高被确定为 ICL 术后发生 DE 症状的危险因素。
ICL 植入对眼表面和 MG 功能有不良影响。在存在 DE 的患者中，这种影响可能更为明显。
