Clinical Research Center, School of Optometry, University of California, Berkeley, California, United States of America.
Vision Science Group, University of California, Berkeley, California, United States of America.
PLoS One. 2021 Jun 28;16(6):e0247877. doi: 10.1371/journal.pone.0247877. eCollection 2021.
To examine the relationship between pre-corneal and pre-contact lens tear film stability (TFS), and to determine whether pre-corneal TFS is a reliable predictor of subsequent pre-lens TFS after a contact lens is placed on the eye.
667 records met inclusion criteria and were extracted from a soft contact lens multi-study database. Multivariable linear mixed effects models were fit to examine the association between pre-corneal and pre-lens TFS, adjusting for potential confounders and accounting for repeated measures. Receiver Operating Characteristic (ROC) analysis was employed to assess the predictive performance of pre-corneal TFS for subsequent pre-lens TFS. TFS was quantified for this analysis as the non-invasive tear breakup time (NITBUT).
Pre-corneal NITBUT was significantly related to the pre-lens NITBUT at both 10 min (p<0.001) and 2-6 hrs (p<0.001) post-lens insertion. However, the sensitivities of pre-corneal NITBUT for predicting symptom-associated thresholds of pre-lens NITBUT ranged from 50-65%, and specificities ranged from 57-72%, suggesting poor-to-moderate diagnostic performance.
Despite the association of pre-corneal and pre-lens TFS, the inherent lability and sensitivity to environmental exposures of the tear film introduce significant variability into NITBUT measurements. Using pre-corneal NITBUT to identify likely successful contact lens candidates prior to fitting is thus not sufficiently accurate to be relied upon in the clinical setting.
研究角膜前泪膜和接触镜前泪膜稳定性（TFS）之间的关系，并确定角膜前 TFS 是否可作为放置接触镜后角膜前 TFS 的可靠预测指标。
从软性隐形眼镜多研究数据库中提取符合纳入标准的 667 条记录。采用多变量线性混合效应模型来检验角膜前和接触镜前 TFS 之间的关系，调整潜在混杂因素并考虑重复测量。采用受试者工作特征（ROC）分析评估角膜前 TFS 对随后接触镜前 TFS 的预测性能。这项分析中 TFS 是通过非侵入性泪膜破裂时间（NITBUT）来量化的。
角膜前 NITBUT 与接触镜后 10 分钟（p<0.001）和 2-6 小时（p<0.001）时的接触镜前 NITBUT 显著相关。然而，角膜前 NITBUT 预测与症状相关的接触镜前 NITBUT 阈值的灵敏度范围为 50-65%，特异性范围为 57-72%，表明诊断性能较差至中等。
尽管角膜前和接触镜前 TFS 之间存在关联，但泪膜的固有不稳定性和对环境暴露的敏感性会导致 NITBUT 测量值存在很大差异。因此，在临床环境中，使用角膜前 NITBUT 来识别可能成功的接触镜候选者并不可靠。
