眼表综合分析仪对老年干眼病患者睑板腺检查的应用研究

Application of OCULUS Keratograph to analyze the condition of the meibomian gland in dry eyes of older adults

目的探讨眼表综合分析仪分析老年干眼病患者睑板腺情况。方法我院眼科门诊2015年1月-2016年12月诊治60岁以上干眼症患者382例(764只眼),裂隙灯显微镜下进行眼前节检查,包括睑板腺开口状况、睑板腺脂质分泌物性状,眼表综合分析仪进行非侵入性泪膜破裂时间(noninvasive break-up time,NIBUT)检查,包括首次泪膜破裂时间(noninvasive first tear breakup time,NIBUTf)和平均泪膜破裂时间(noninvasive average tear breakup time,NIBUTavg);以及睑板腺拍摄,观察睑板腺形态及睑板腺缺失面积。结果随着年龄增加,NIBUTf和NIBUTavg变短,不同年龄组间测量值差异具有统计学意义(P<0.01)。睑板腺腺体随着年龄的增加数量减少,腺体变细,腺体大片缺失,60岁以上老年干眼病患者均患有不同程度睑板腺功能障碍。结论眼表综合分析仪能客观精准地检查出干眼症患者的泪液和睑板腺情况,为干眼症的病因诊断提供判断依据,更好的为患者个性化治疗提供临床指导。

Objective To analyze the condition of the meibomian gland in dry eyes of older adults by OCULUS Keratograph.Methods A total of 382 patients（764 eyes） who were over 60 patients with dry eyes in our hospital were examined from January 2015 to December 2016. They were devided 3 groups according to age. Ocular anterior segment,including the meibomian gland orifices and meibomian gland lipid secretions,were examined by slit lamp microscope. Noninvasive breakup time（NIBUT）,including noninvasive first tear breakup time（NIBUTf） and noninvasive average tear breakup time（NIBUTavg） were examined by OCULUS Keratograph. We aslo evaluated the condition of the meibomian gland by OCULUS Keratograph,including the shape of the meibomian gland and the loss area of the meibomian gland. Results NIBUTf and NIBUTavg became shorter with increasing age,and the differences between groups were statistically significant（P〈0.05）. With increasing age,the numbers of the meibomian glands decreased,the meibomian glands shape became thinner and the loss aera of the meibomian glands increased. The dry eyes of older adults over 60 were suffered varying degrees of meibomian gland dysfunction. Conclusion The OCULUS Keratograph can provide the objective and precise examination of the condition of tear film and meibomian gland in patients with dry eyes. It can provide the diagnosing judgment and personalized treatments for patients with dry eyes.