Liu Tingting, Liu Shulin, Gan Meiqi, He Yuqin, Fu Hongxue, Xu Mei
Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Med (Lausanne). 2022 Mar 2;9:849700. doi: 10.3389/fmed.2022.849700. eCollection 2022.
The study aimed at investigating the changes of dry eye parameters, especially the meibomian gland function in dry eye patients with primary Sjögren's syndrome (SS) and non-Sjögren's syndrome (non-SS) before and after punctal plugs insertion.
The SS and non-SS dry eye patients that received punctal plugs insertion were prospectively investigated. This study recruited fifty patients. The standardized patient evaluation of eye dryness (SPEED), ocular surface disease index (OSDI), tear meniscus height (TMH), non-invasive Keratographic breakup time (NIKBUT), Schirmer test without anesthesia (Schirmer I Test, SI T), corneal fluorescein staining (CFS), the meibomian gland dropout (meiboscore), meibum expressibility score (MES), meibum quality score (MQS), lid margin abnormalities and the lipid layer thickness (LLT) were analyzed at pre-obstruction, 2 weeks, 2 months and 6 months following the obstruction.
Our study observed a statistically significant improvement in ocular symptom scores (SPEED and OSDI scores) after punctal plugs insertion at every visit in both SS and non-SS patients (all < 0.05). A similar pattern was observed in TMH, SI T, NIKBUT and CFS score in both groups (all < 0.05), except that NIKBUT and CFS score had no obvious change in SS group at 6 months ( > 0.05). In terms of the meibomian gland evaluation, meiboscore did not change significantly, MES decreased at 2 and 6 months and MQS decreased only at 2 months in both groups. The lid margin abnormalities of the non-SS group were significantly improved at 2 and 6 months, while that of the SS group had changes only at 2 months. Interestingly, LLT in non-SS group continued to rise, reaching a higher level at 2 months ( < 0.05), while LLT in SS group increased only at 2 months ( < 0.05). Meanwhile, after the puntcal plugs insertion, non-SS group showed better outcomes concerning some parameters, such as lower ocular symptom scores, higher TMH and significantly greater LLT, compared with that in SS group (all < 0.05).
Our study revealed that dry eye symptoms and signs, including meibomian gland function, improved for at least 6 months in non-SS dry eye patients as well as in SS dry eye patients after punctal plugs insertion.
本研究旨在调查原发性干燥综合征（SS）和非干燥综合征（非SS）的干眼患者在插入泪点塞前后干眼参数的变化，尤其是睑板腺功能的变化。
对接受泪点塞插入的SS和非SS干眼患者进行前瞻性研究。本研究招募了50名患者。在阻塞前、阻塞后2周、2个月和6个月分析标准化干眼患者评估（SPEED）、眼表疾病指数（OSDI）、泪膜半月板高度（TMH）、无创角膜破裂时间（NIKBUT）、无麻醉下的Schirmer试验（Schirmer I试验，SIT）、角膜荧光素染色（CFS）、睑板腺缺失（睑板腺评分）、睑脂排出能力评分（MES）、睑脂质量评分（MQS）、睑缘异常和脂质层厚度（LLT）。
我们的研究观察到，SS和非SS患者在每次随访时插入泪点塞后眼部症状评分（SPEED和OSDI评分）均有统计学意义的改善（均P<0.05）。两组的TMH、SIT、NIKBUT和CFS评分也观察到类似模式（均P<0.05），但SS组在6个月时NIKBUT和CFS评分无明显变化（P>0.05）。在睑板腺评估方面，两组的睑板腺评分均无显著变化，MES在2个月和6个月时降低，MQS仅在2个月时降低。非SS组的睑缘异常在2个月和6个月时显著改善，而SS组仅在2个月时有变化。有趣的是，非SS组的LLT持续上升，在2个月时达到更高水平（P<0.05），而SS组的LLT仅在2个月时增加（P<0.05）。同时，插入泪点塞后，与SS组相比，非SS组在一些参数方面显示出更好的结果，如更低的眼部症状评分、更高的TMH和显著更高的LLT（均P<0.05）。
我们的研究表明，非SS干眼患者和SS干眼患者在插入泪点塞后，干眼症状和体征，包括睑板腺功能，至少在6个月内有所改善。
