睑板腺检查前后脂质层厚度变化的研究

Changes of the lipid layer thickness before and after the meibomian gland examination

目的使用LipiView眼表面光干涉仪研究患者行睑板腺检查前后泪膜脂质层厚度(LLT)的变化。方法使选取2019年5~10月在武汉爱尔眼科医院就诊的42例(84只眼)干眼患者作为试验组,选择42例(84只眼)健康人作为对照组。所有入选者都按照以下顺序进行检查:使用LipiView眼表面光干涉仪计算LLT,用Keratograph 5M眼表综合分析仪(OCULUS,德国)进行睑板腺红外照相检查,再次应用LipiView眼表面光干涉仪计算LLT。比较试验组与对照组睑板腺检查后LLT的变化。结果使使用LipiView眼表面光干涉仪检查试验组及对照组睑板腺检查前后LLT,试验组睑板腺检查前LLT为46.50(39.00~56.75)nm,检查后LLT为70.00(66.00~80.00)nm,对照组睑板腺检查前LLT为87.00(79.00~90.75)nm,检查后LLT为98.50(91.00~100.00)nm,试验组与对照组睑板腺检查后LLT均显著高于检查前(试验组P<0.001,对照组P<0.001)。结论无论干眼患者还是健康人群,睑板腺检查后LLT明显高于睑板腺检查前,临床工作中LLT测量应该在睑板腺检查前完成。

Objective To evaluate the changes of the lacrimal lipid layer thickness(LLT)before and after meibomian gland examination using the LipiView ocular surface light interferometer.Methods A total of 84 eyes from 42 patients with dry eye at the Wuhan Eye Hospital from May 2019 to October 2019 were selected as the test group,and 84 eyes from 42 healthy people were selected as the control group.All participants were examined in the following order:measurement of the LLT thickness using the LipiView,examination of the meibomian gland infrared photography with the Keratograph 5M(OCULUS,Germany),and the LLT measurement was performed again.The changes of the LLT before and after the meibomian gland examination were compared between the test group and the control group.Results The LLT before and after the meibomian gland examination was 46.50(range:39.00~56.75)nm and 70.00(range:66.00~80.00)nm in the test group,and was 87.00(range:79.00~90.75)nm and 98.50(range:91.00~100.00)nm in the control group.The LLT significantly increased after the examination of meibomian gland in both groups(test group:Z=7.476,P<0.001;control group:Z=7.676,P<0.001).Conclusions The LLT after meibomian gland examination is significantly higher than that before the examination in both dry eye patients and healthy people.The thickness measurement of the LLT in clinical practice should be completed before the meibomian gland infrared photography examination.