Chen Ming, Hedges Jerris R, Choi So Yung, Liu Keke, Lin Szu Yuan
Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA.
John A. Burns School of Medicine, Honolulu, HI, USA.
Taiwan J Ophthalmol. 2021 Jun 10;12(2):198-201. doi: 10.4103/tjo.tjo_15_21. eCollection 2022 Apr-Jun.
To investigate if larger punctum size links to the severity of dry eye disease (DED) and perhaps, punctum size inspection can be adopted to become one of the DED evaluations for practitioners. The records of 200 eyes of 114 patients that had temporary collagen punctum plugs due to severe DED (Level 2 to Level 4) from January 1, 2017, to July 31, 2018, were reviewed for the size of the plugs. Lacrimal punctum size of those eyes was approximated according to the size of vertical canalicular soft collagen plug (from 0.3 to 0.5 mm diameter, Oasis, Lacrimedics, Glendora, CA, USA). The dry eye severity grading from the International Dry Eye WorkShop was used to grade the level of the severity of DED. Those eyes classified as Level 2 and above were considered as severe due to the presentation of moderate-to-diffuse corneal staining and symptomatic. To assess if there is a correlation between punctum size and the severity of DED, the Spearman's rank correlation coefficient was calculated. Of the 200 Level 2 and above eyes, 131 (66%) eyes had a large punctum (≥0.5 mm). Punctum size larger than 0.4 mm was 95%. The estimated Spearman's ρ was 0.16. This indicates a statistical significant positive correlation ( = 0.02) between larger punctum size and higher level of DED. The larger size of lacrimal punctum may link to the severity of DED. Punctum inspection may be adopted to become one parameter for DED evaluation for practitioners.
为研究较大的泪小点尺寸是否与干眼病（DED）的严重程度相关，以及泪小点尺寸检查是否可被从业者用作DED评估指标之一。回顾了2017年1月1日至2018年7月31日期间114例因重度DED（2级至4级）而植入临时胶原泪小点栓子的患者的200只眼的记录，以了解栓子的尺寸。根据垂直泪小管软胶原栓子的尺寸（直径0.3至0.5毫米，美国加利福尼亚州格伦多拉市Lacrimedics公司的Oasis产品）估算这些眼睛的泪小点尺寸。采用国际干眼病研讨会的干眼严重程度分级标准对DED的严重程度进行分级。由于出现中度至弥漫性角膜染色且有症状，那些被分类为2级及以上的眼睛被视为重度干眼。为评估泪小点尺寸与DED严重程度之间是否存在相关性，计算了Spearman等级相关系数。在200只2级及以上的眼中，131只（66%）眼睛的泪小点较大（≥0.5毫米）。泪小点尺寸大于0.4毫米的占95%。估计的Spearman ρ为0.16。这表明较大的泪小点尺寸与较高程度的DED之间存在统计学上的显著正相关（P = 0.02）。较大的泪小点尺寸可能与DED的严重程度相关。泪小点检查可被从业者用作DED评估的一个参数。
