睑板腺分泌物与干眼症关系的研究

目的:了解异常睑板腺分泌物和干眼症的关系。方法:在门诊连续观察68例共136眼。常规检查视力和矫正视力、眼球前段和眼底检查。进行泪膜破裂时间(BUT),SchirmerⅠ试验和角膜虎红染色(rb)并评分,观察记录睑板腺分泌物的性质。按病情轻重将干眼症分为轻度和重度。结果:蛋清样分泌物28眼,奶黄样分泌物26眼,颗粒状分泌物30眼,牙膏状分泌物52眼。干眼症指标3项显示,在蛋清样,奶黄样,颗粒状和牙膏状睑板腺分泌物中,BUT积分和rb积分呈阶梯状依次增高,牙膏状分泌物组的BUT和rb积分明显高于其它3组,(两两比较,P均<0.01)。各组SchirmerⅠ积分均在1分以下,组间无差别。有54眼(40%)符合干眼症诊断标准,各组患干眼症的构成比依次升高为:蛋清样(2/28)7.1%;奶黄样(4/26)15%;颗粒状(8/30)27%;牙膏状(40/52)77%。颗粒状分泌物发生干眼症高于蛋清样组(P<0.05),而牙膏状分泌物发生干眼症明显高于其它3组(P<0.01)。蛋清样和奶黄样分泌物组无重度干眼症患者,8眼颗粒状分泌物中重度干眼症占2眼,而40眼牙膏状分泌物中19眼发生重度干眼症。牙膏状分泌物发生重度干眼症高于非牙膏状分泌物(P<0.05)。结论:异常睑板腺分泌物影响眼表面的稳定性,其中牙膏状分泌物患者易患干眼症,干眼症程度较其它分泌物组重。

Abnormal Property of Meibomian Secretion and Dry Eye Syndrome

PURPOSE: To study the relationship between meibomian secretion and dry eye. METHODS: To observe 68 outpatients (136 eyes) consecutively. Routine check up included vision, anterior segment and fundus, scoring of tear break up time (BUT), Schirmer I test and rose bengal staining (rb). Recorded the property of meibomian secretion. Defined the dry eye as mild and severe. RESULTS: Meibomian secretion was sorted as egg-white-like secretion (n=28), milk-yellowish secretion (n=26), granular secretion (n=30) and toothpaste-like secretion (n=52). The result declared that BUT and rb scoring stepped up consecutively in the above secretions, that was higher in toothpaste-like secretion than in other groups (all P < 0.01). Schirmer I scoring was below 1 in all groups, and there was no difference in the groups. Fifty-four eyes (40%) met the criteria of dry eye syndrome. The incidence of dry eye stepped up in groups as egg-white-like secretion (2/28) 7.1%, milk-yellowish secretion (4/26) 15%, granular secretion (8/30) 27% and toothpaste-like secretion (40/52) 77%. The incidence was higher in granular secretion than in egg-white-like secretion (P < 0.05), while the incidence was higher in toothpaste-like secretion than in any of other 3 groups (P < 0.01). There was no severe dry eye in egg-white-like secretion and milk-yellowish secretion, while dry eye was found in 2 out of 8 in granular secretion, and in 19 out of 40 in toothpaste-like secretion. Incidence of severe dry eye was found higher in toothpaste-like secretion than in non toothpaste-like secretion (P < 0.05). CONCLUSION: Abnormal meibomian secretion affects the stability of ocular surface. The patients with toothpaste-like secretion are prone to dry eye and tend to have a worse dry eye than other secretion groups.