Department of Physiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
PLoS One. 2022 Sep 9;17(9):e0274173. doi: 10.1371/journal.pone.0274173. eCollection 2022.
The preocular tear film is critically important for maintaining healthy ocular surface. In lagophthalmos, increased evaporation and tear film instability can occur. The level of tear matrix metalloproteinase 9 (MMP-9) is considered as a possible marker of ocular surface damage and inflammation. The aim of this study was to evaluate the possible usefulness of measuring tear film levels of MMP-9 in patients with lagophthalmos. Sixteen adult patients with unilateral lagophthalmos due to cerebellopontine angle mass surgery were included. Basic clinical examination including tear film osmolarity, degree of lagophthalmos, ocular surface sensitivity testing, corneal fluorescein staining, and tear break-up time (TBUT) were performed. Furthermore, tear MMP-9 quantification was performed and the values from lagophthalmic and contralateral healthy eye were compared. Possible correlations between tear MMP-9 levels and other parameters were analyzed. The Oxford score was higher in lagophthalmic eyes in comparison to healthy eyes. TBUT and corneal sensitivity were lower in lagophthalmic eyes. There was no difference in osmolarity between the two groups. Tear MMP-9 values were higher in lagophthalmic eyes. A higher MMP-9 value was associated with an increase in ocular surface fluorescein staining and a decrease of TBUT in lagophthalmic eyes. Tear MMP-9 may be used for monitoring ocular surface damage, contribute to early detection of inflammation progression and facilitate treatment adjustments.
瞬目前泪膜对于维持健康的眼表面至关重要。在睑裂闭合不全时，可能会发生蒸发增加和泪膜不稳定。泪液基质金属蛋白酶 9（MMP-9）的水平被认为是眼表面损伤和炎症的可能标志物。本研究旨在评估测量睑裂闭合不全患者泪膜中 MMP-9 水平的可能有用性。纳入了 16 例因桥小脑角肿块手术导致单侧睑裂闭合不全的成年患者。进行了基本的临床检查，包括泪膜渗透压、睑裂闭合不全程度、眼表面敏感性测试、角膜荧光素染色和泪膜破裂时间（TBUT）。此外，还进行了泪 MMP-9 的定量检测，并比较了睑裂闭合不全眼和对侧健康眼的数值。分析了泪 MMP-9 水平与其他参数之间的可能相关性。与健康眼相比，睑裂闭合不全眼的牛津评分更高。睑裂闭合不全眼的 TBUT 和角膜敏感性较低。两组之间的渗透压没有差异。睑裂闭合不全眼的泪 MMP-9 值较高。在睑裂闭合不全眼中，MMP-9 值越高，眼表面荧光素染色增加，TBUT 降低。泪 MMP-9 可用于监测眼表面损伤，有助于早期发现炎症进展，并有助于调整治疗。
