Kim Eun Chul, So Ha-Rim, Kim Sung Eun, Yang Suk-Woo
Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, #222 Banpo-Daero, Seocho-Gu, Seoul, 06591, Korea.
Int Ophthalmol. 2025 Mar 14;45(1):93. doi: 10.1007/s10792-025-03484-8.
To evaluate the effect of levator palpebrae superioris in patients with dry eye disease.
168 eyes of 84 patients (group 1 = fair levator function ≤ 9 mm, 78 eyes; group 2 = good levator function > 9 mm, 90 eyes) were retrospectively enrolled. Levator function test, Ocular Surface Disease Index Questionnaire (OSDI), Schirmer I test, noninvasive tear break up time (NItBUT), corneal staining score, meibography, meibum quality and expressibility scores, tear meniscus height, and partial blinking rate (PBR) were examined.
There was no statistically significant differences between group 1 (0.45 ± 0.76) and 2 (0.58 ± 0.76) according to OSDI and corneal stain (P > 0.05). PBR and NItBUT in group 2 (9.29 ± 4.01 and 4.76 ± 2.39, respectively) were significantly worse than those in group 1 (5.88 ± 3.99 and 5.78 ± 2.94, respectively) (P < 0.05). There was a significantly positive correlation between levator function and partial blinking rate (R = 0.4114, P = 0.0002). Meibum expressibility and lipid thickness in group 2 (0.48 ± 0.70 and 1.39 ± 0.45, respectively) were significantly better than those in group 1 (1.29 ± 0.65 and 1.12 ± 0.33, respectively) (P < 0.05) (Fig. 3). There was a significantly negative correlation between levator function and meibum expressibility grade (R = -0.3869, P = 0.0006) (Fig. 5).
The eyes with good levator function showed shorter tear break-up time due to a higher partial blinking rate, but showed better lipid thickness due to better meibum expressibility compared with the eyes with fair levator function. Evaporative dry eye disease in the eyes with good levator function can be compensated for by a better meibum expressibility.
评估上睑提肌在干眼症患者中的作用。
回顾性纳入84例患者的168只眼（第1组=上睑提肌功能尚可≤9mm，78只眼；第2组=上睑提肌功能良好>9mm，90只眼）。检查上睑提肌功能测试、眼表疾病指数问卷（OSDI）、泪液分泌试验、非侵入性泪膜破裂时间（NItBUT）、角膜染色评分、睑板腺照相、睑脂质量和排出能力评分、泪河高度及不完全眨眼率（PBR）。
根据OSDI和角膜染色，第1组（0.45±0.76）和第2组（0.58±0.76）之间无统计学显著差异（P>0.05）。第2组的PBR和NItBUT（分别为9.29±4.01和4.76±2.39）显著差于第1组（分别为5.88±3.99和5.78±2.94）（P<0.05）。上睑提肌功能与不完全眨眼率之间存在显著正相关（R=0.4114，P=0.0002）。第2组的睑脂排出能力和脂质厚度（分别为0.48±0.70和1.39±0.45）显著优于第1组（分别为1.29±0.65和1.12±0.33）（P<0.05）（图3）。上睑提肌功能与睑脂排出能力分级之间存在显著负相关（R=-0.3869，P=0.0006）（图5）。
与上睑提肌功能尚可的眼睛相比，上睑提肌功能良好的眼睛因不完全眨眼率较高而泪膜破裂时间较短，但因睑脂排出能力较好而脂质厚度更佳。上睑提肌功能良好的眼睛中的蒸发型干眼症可通过更好的睑脂排出能力得到代偿。
