Department of Ophthalmology, University Hospital, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Ocular Surface Center Berlin (OSCB), Berlin, Germany.
Curr Eye Res. 2021 Oct;46(10):1489-1494. doi: 10.1080/02713683.2021.1896741. Epub 2021 Mar 22.
: Involutional changes of lid structures often induce horizontal lid laxity; this can result in a reduction of Meibomian gland expression, potentially leading to symptoms of dry eye. The aim of this study was to evaluate the effect of tightening the lower eyelid via a lateral canthal sling (LCS) procedure on dry eye parameters.: Patients with Meibomian Gland Dysfunction (MGD), lower lid laxity (positive Snap-back Test and positive Pinch Test) and no previous lid surgery were evaluated before and 3 months after LCS procedure for symptoms by OSDI. The fellow eye without surgery functioned as a control group. MGD parameters included lipid layer thickness (LLT), non-invasive breakup time (NIBUT), tear meniscus height, loss of Meibomian glands, lid margin parallel conjunctival folds (LIPCOFs), Schirmer's test, the number of expressible Meibomian glands as well as quality of Meibum.: Fourteen patients (8 men and 6 women; 79.2 ± 4.0 years) were enrolled in this prospective clinical study. After 3 months, the OSDI showed a significant reduction (preop 42.9 ± 24.7; postop 23.8 ± 21.6; = .002); NIBUT (5.5 ± 2.6 s to 9.9 ± 6.8 s = .08) and LLT (64.3 ± 30.4 to 74.1 ± 27.8; = .025) improved, while Schirmer Test (15.3 ± 4.7 mm to 11.9 ± 2.9 mm; = .03) and tear meniscus height were reduced (0.8 ± 0.3 to 0.6 ± 0.2; = .05). Meibomian gland loss scored by the meiboscale slightly increased postoperatively (1.2 ± 0.9 to 1.4 ± 0.9; = .18). The number of expressible Meibomian glands improved (4.4 ± 2.6 to 6.8 ± 2.1, = .002) as well as the quality of Meibum (0.9 ± 1.0 to 0.5 ± 0.8, = .04). Snap back test as well the pinch test were negative in all patients postoperatively.: Addressing lower lid laxity with an LCS procedure simultaneously enhances tear drainage, reduces tear film volume parameters and increases tear film stability results with an improvement of dry eye symptoms. It is likely that increased lower eyelid tension and thus excretory pressure on the Meibomian glands is responsible for these alterations.
: 眼睑结构的进行性变化常导致水平眼睑松弛; 这可能导致睑板腺分泌减少，潜在导致干眼症状。本研究旨在评估通过外侧眦悬吊术 (LCS) 收紧下眼睑对干眼参数的影响。: 患有睑板腺功能障碍 (MGD)、下眼睑松弛 (Snap-back 试验和 Pinch 试验阳性) 且无先前眼睑手术的患者在 LCS 手术后 3 个月时通过 OSDI 评估症状。未手术的对侧眼作为对照组。MGD 参数包括脂质层厚度 (LLT)、非侵入性泪膜破裂时间 (NIBUT)、泪膜高度、睑板腺丢失、睑缘平行结膜褶皱 (LIPCOFs)、Schirmer 试验、可表达的睑板腺数量以及睑脂质量。: 本前瞻性临床研究共纳入 14 例患者 (8 名男性和 6 名女性; 79.2 ± 4.0 岁)。3 个月后，OSDI 显著降低 (术前 42.9 ± 24.7; 术后 23.8 ± 21.6; =.002); NIBUT (5.5 ± 2.6 s 至 9.9 ± 6.8 s =.08) 和 LLT (64.3 ± 30.4 至 74.1 ± 27.8; =.025) 改善，而 Schirmer 试验 (15.3 ± 4.7 mm 至 11.9 ± 2.9 mm; =.03) 和泪膜高度降低 (0.8 ± 0.3 至 0.6 ± 0.2; =.05)。术后 Meibom 量表评估的睑板腺丢失略有增加 (1.2 ± 0.9 至 1.4 ± 0.9; =.18)。可表达的睑板腺数量增加 (4.4 ± 2.6 至 6.8 ± 2.1， =.002)，睑脂质量改善 (0.9 ± 1.0 至 0.5 ± 0.8， =.04)。术后所有患者的 Snap-back 试验和捏夹试验均为阴性。: 通过 LCS 手术解决下眼睑松弛问题，同时增强泪液引流，减少泪膜容积参数，增加泪膜稳定性，改善干眼症状。睑板腺分泌增加可能是由于下眼睑张力增加，从而增加了睑板腺的排泄压力。
