Gong Qianwen, Li Anqi, Chen Lin, Chen Huijuan, Gu Jinjing, Xu Zhiqiang, Lu Fan, Hu Liang
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
National Clinical Research Center for Ocular Diseases, Wenzhou, China.
Front Med (Lausanne). 2022 Apr 25;9:833984. doi: 10.3389/fmed.2022.833984. eCollection 2022.
To investigate the effect of the preoperative meibomian gland (MG) status on dry eye symptoms after corneal refractive surgery.
This is a prospective, observational study. Subjects were enrolled and classified into 3 groups according to their MG loss grades. Ocular surface parameters were measured preoperatively and at 1, 3, and 6 months, postoperatively, including the ocular surface disease index questionnaire (OSDI), non-invasive tear film break up time (NIBUT), tear meniscus height and Schirmer I test. All the parameters were analyzed among the three groups, and different time points.
Seventy-eight patients were included in this study. The grade of MG loss varied from 0 to 2, thus the subjects were divided into group 1-3 corresponding to the MG loss. There were no significant differences in all parameters at baseline. The OSDI score increased in all groups at 1 month postoperatively and then decreased after other follow-ups. The OSDI was higher in group 3 than group 1 at all time points postoperatively ( = 0.005, 0.002, 0.034). Besides, it was higher in group 2 at 3 months and 6 months, compared with group 1 ( = 0.006, 0.029). The average NIBUT was shorter in group 3, compared with group 1 and group 2 since 1 month after surgery. At 1 and 3 month postoperatively, the grade of MG loss was positively correlated with the total OSDI and the vision-related scores. And it showed a positive correlation only with the environmental score at 6 months postoperatively.
The dry eye discomfortable symptoms significantly differed post operatively according to their preoperative MG loss grade, though no difference was found at baseline. Dry eye was associated more with vision-related discomfort at first and environmental factors later.
探讨术前睑板腺（MG）状态对角膜屈光手术后干眼症状的影响。
这是一项前瞻性观察研究。根据睑板腺缺失程度将受试者纳入并分为3组。术前及术后1、3和6个月测量眼表参数，包括眼表疾病指数问卷（OSDI）、非侵入性泪膜破裂时间（NIBUT）、泪河高度和泪液分泌试验I。对三组及不同时间点的所有参数进行分析。
本研究纳入78例患者。睑板腺缺失程度从0到2不等，因此受试者分为与睑板腺缺失相对应的1-3组。基线时所有参数均无显著差异。术后1个月所有组的OSDI评分均升高，随后在其他随访中降低。术后所有时间点3组的OSDI均高于1组（P = 0.005、0.002、0.034）。此外，与1组相比，2组在3个月和6个月时更高（P = 0.006、0.029）。自术后1个月起，3组的平均NIBUT较1组和2组更短。术后1个月和3个月，睑板腺缺失程度与总OSDI及视力相关评分呈正相关。术后6个月仅与环境评分呈正相关。
尽管基线时未发现差异，但术后干眼不适症状根据术前睑板腺缺失程度有显著差异。干眼最初更多与视力相关不适有关，后来与环境因素有关。
