干眼患者泪膜脂质层厚度检测及其与眼表体征的相关性分析

目的 检测干眼患者泪膜脂质层厚度(lipid layer thickness,LLT),并分析LLT与眼表体征之间的相关性.方法 纳入130例(130眼)干眼患者为本研究研究对象,其中睑板腺功能障碍(meibomian gland dysfunction,MGD)患者64例,非MGD患者66例,进行LLT检测、泪膜破裂时间(break-up time,BUT)检查、角膜荧光素染色(fluorescein staining,FL)、Marx线(Marx line,ML)评分及Schirmer Ⅰ试验.分析不同年龄段LLT分布情况,及其与其他检查之间的相关性.结果 不同年龄段之间LLT差异有统计学意义(P =0.007),各年龄段男性与女性之间LLT差异均无统计学意义(均为P＞0.05).LLT与年龄呈正相关(r =0.334,P＜0.001),LLT与性别无显著相关性(r=0.107,P=0.226).LLT与上睑ML评分(r=0.295,P=0.001)、下睑ML评分(r=0.233,P=0.008)呈正相关,与BUT、FL及泪液分泌量均无显著相关性(均为P＞0.05).MGD组LLT与上睑ML评分、下睑ML评分呈正相关(均为r=0.306,P=0.014),与其他检查指标均无显著相关性(均为P＞0.05).非MGD组LLT与其他检查指标均无显著相关性(均为P＞0.05).多元线性回归分析结果显示,干眼患者中,年龄、上睑ML评分与LLT存在线性关系(年龄:β=0.254,P=0.005;上睑ML评分:β=0.207,P=0.022),在MGD组中,仅年龄与LLT存在线性关系(β=0.382,P=0.002).MGD组上睑ML评分及下睑ML评分均高于非MGD组(均为P＜0.001).结论 干眼患者LLT与年龄、ML评分呈正相关.泪膜LLT检测作为干眼诊断的辅助检查时,需结合年龄等影响因素进行综合分析.     

不同脂质层厚度干眼患者泪膜稳定性的观察研究

目的:探讨不同脂质层厚度条件下泪膜稳定性的差异。方法:纳入2020-06/2021-12于我院就诊的干眼患者194例384眼,应用角膜地形图仪行双眼泪河高度、首次泪膜破裂时间和脂质层厚度测量,分析不同脂质层厚度条件下双眼泪河高度、首次泪膜破裂时间的差异及其相关性。结果:根据脂质层厚度将纳入患者(384眼)分为脂质丰富组(49眼)、脂质平衡组(27眼)、脂质轻微缺乏组(266眼)、脂质显著缺乏组(42眼),四组泪河高度有差异(P=0.022),首次泪膜破裂时间无差异(P=0.322)。脂质层厚度分级与泪河高度呈正相关(r_s=0.143,P=0.006),与首次泪膜破裂时间无相关性(r_s=-0.090,P=0.083);泪河高度与首次泪膜破裂时间也无相关性(r_s=0.038,P=0.460)。结论:泪膜脂质层厚度不同的干眼患者泪膜稳定性无明显差异。     

The correlation between the tear film lipid layer and dry eye disease

Dry eye, also known as keratoconjunctivitis sicca, can be due either to insufficient tear production or excessive tear evaporation, both resulting in tear hyperosmolarity that leads to symptoms of discomfort and ocular damage. Additionally, the severity of dry eye symptoms appears to be correlated to lipid layer thickness. It is now generally recognized that increased evaporation due to a compromised lipid layer is one of the most common etiologies for hyperosmolarity of the tear film. Thus, therapies targeted at replenishing or stabilizing the lipid layer are key to the treatment of dry eye, either as monotherapy or in conjunction with therapies designed to enhance aqueous production.     

原发性获得性鼻泪管阻塞对泪膜及眼表的影响

目的：利用LipiView眼表面干涉仪和Keratograph 5M眼前节分析仪观察原发性获得性鼻泪管阻塞(PANDO)对泪膜及眼表的影响。方法：自身对照临床试验研究。将2021-09/2022-03我科收治的单侧PANDO且病程在6mo以上的患者40例纳入研究,以健眼作为对照。采用LipiView眼表面干涉仪和Keratograph 5M眼前节分析仪测量并分析双眼泪膜及眼表相关参数的差异。结果：纳入患者患眼非侵入性泪河高度(NITMH)、刺激后NITMH、上睑板腺缺失率、鼻颞侧睫状眼红指数、颞侧结膜眼红指数均高于健眼(P<0.05),但双眼非侵入性泪膜破裂时间(NIBUT)、下睑板腺缺失率、鼻侧结膜眼红指数、干眼分级、眨眼次数、不完全眨眼率、泪膜脂质层厚度(LLT)均无差异(P>0.05)。结论：PANDO可能导致眼表炎症加重及上睑板腺缺失,损害患者眼表健康,应重视早期PANDO的治疗。     

Low concentration of sodium hyaluronate temporarily elevates the tear film lipid layer thickness in dry eye patients with lipid deficiency

AIM: To investigate the effects of different concentrations of artificial tears on lipid layer thickness (LLT) and blink rate (BR) in dry eye patients. METHODS: This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline <75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate (SH) eye drops by using the LipiView ocular surface interferometer. RESULTS: In the lipid deficiency group, the LLT increased from baseline at 1min post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH (P<0.001). The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at 1min and returned to baseline at 5min for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION: SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. In comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.     

干眼患者泪液结晶图和脂质层异常的关系研究

目的：评估干眼患者泪液结晶图中外层透明带的临床意义,探索评估泪液脂质层的新方法。

方法：随机选取2018-05/2019-07于在我院就诊的干眼患者47例47眼(均取右眼数据进行分析),所有入组患者均行眼表疾病指数(OSDI)问卷评分,采用DR-1泪膜干涉成像仪行脂质层分级检测,眼表综合分析仪行非侵入式泪膜破裂时间(NIBUT)和泪河高度检查,采集泪液行泪液结晶试验,拍摄泪液结晶图全貌,使用Digimizer软件测量结晶图,计算结晶图外层透明带的面积占比,并分析其与OSDI评分、脂质层分级、泪河高度、NIBUT的相关性。

结果：本研究纳入患者泪液结晶图透明带面积占比与OSDI评分呈负相关(r=-0.764,P<0.05),与DR-1成像仪脂质层分级呈负相关(r=-0.838,<0.05),与NIBUT呈正相关(r=0.575,P<0.05),与泪河高度无明显相关(r=-0.237,P=0.112)。

结论：检测泪液结晶图外层透明带可有效评估泪液脂质层情况,透明带面积占比越大,脂质层越厚。该检测方法具有结果可量化、重复性较好、设备要求低等优点。     

蒸发过强型干眼的泪膜脂质层成分变化及治疗策略

泪膜包括脂质层和由水及黏蛋白构成的凝胶层,其中脂质层又分为极性和非极性两层。非极性脂质的成分为蜡酯、固醇酯、甘油三酯等,而极性脂质层主要是磷脂类。蒸发过强型干眼患者的泪膜脂质层成分不同于正常者,而泪液脂质层对于稳定泪膜、减少蒸发具有重要意义,因此蒸发过强型干眼治疗的关键在于补充和稳定泪膜脂质,既可以作为单一疗法也可以联合补充泪液的治疗。     

Adsorption of apo- and holo-tear lipocalin to a bovine Meibomian lipid film

Adsorption of apo- and holo-tear lipocalin (Tlc) to bovine Meibomian lipid film was studied. A Langmuir trough was used for these studies and the adsorption of protein was observed by recording changes in the pressure with time (pi-T profile). The films were photographed at different stages of adsorption by doping Meibomian lipids with a fluorescently tagged lipid. The results indicated that apo-Tlc adsorbed much more quickly than holo-Tlc to the Meibomian lipid film. Contrary to the expectation that holo-Tlc would release lipids to the surface and surface pressure would be higher, it was found that the surface pressure was higher with the adsorption of apo-Tlc to the surface. Photography of the films showed that apo- and holo-Tlc interacted differently with the Meibomian lipid layer. Adsorption of holo-Tlc resulted in big bright patches and adsorption of apo-Tlc resulted in many small patches along with the big patches. Both forms of Tlc produced a more stable film as indicated by decreased movement of the protein adsorbed films, and a higher maximum surface pressure upon compression of these films compared with Meibomian lipid films alone. Isocyles of apo-Tlc adsorbed films gave a higher surface pressure than that of holo-Tlc. From these results, it is concluded that both apo- and holo-Tlc adsorbed to the Meibomian lipid layer and the delivery of the lipids from Tlc to the outer lipid layer could not be detected by our techniques. Its scavenging role to remove lipids from the corneal surface and bind with them might be beneficial for increasing tear viscosity but whether those lipids are delivered to the outermost lipid layer still remains unclear.     

Changes of tear film lipid layer thickness by 3% diquafosol ophthalmic solutions in patients with dry eye syndrome

AIM: To evaluate the quantitatively changes in lipid layer thickness (LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. METHODS: A total 124 participants (32 males, 92 females; mean age, 28.9y) diagnosed with dry eye disease (DED) received topical instillation of 4 ophthalmic solutions in one eye: diquafosol, normal saline, 0.1% sodium hyaluronate and 0.3% gatifloxacin, in a masked manner. LLT was measured using an interferometer at baseline and 20min after the instillation of each ophthalmic solutions. RESULTS: Changes of LLT after instillation (nm, mean± standard error) were as follows: 12.6±2.0 for diquafosol (P<0.001), 1.2±2.2 for normal saline (P=0.301), 1.5±2.0 for hyaluronate (P=0.495), and 0.5±3.2 for gatifloxacin (P=0.884). CONCLUSION: Topical instillation of diquafosol increases tear film LLT in DED patients. Diquafosol 3% eye drop might be effective treatment option of evaporative DED with meibomian gland dysfunction.     

Kinetic analysis of topographical parameters and interference pattern of tear lipid layer in normal subjects

Purpose: To investigate the post‐blink changes of the topographical regularity indices, the corneal wavefront aberrations and the tear lipid layer’s interference pattern, and analyze the relationship between these parameters’ changes. Methods: Sequential topographical measurements were recorded on 23 normal participants. The surface regularity index (SRI), surface asymmetry index (SAI), corneal total higher order aberrations (HOA) root mean square (RMS), Coma RMS and Spherical RMS were calculated from the topographical measurement. The incidence of the type 1 (with an initial decrease after blink) alteration trend, and the times to the initial minimum were determined in every parameter. The movement of the tear lipid layer’s interference pattern was recorded, and the spreading time of the lipid layer was measured subjectively by three independent observers. Results: The incidence of the type 1 SRI trend (82%) was the most common among those measured. The average time to the type 1 SRI trends’ minimum was 4.05 ± 1.46 s. There was no correlation between the time to the minimum of type 1 trends of the topographical indices, the HOA, Coma and Spherical RMS. The mean lipid layer spreading time was 5.09 ± 1.90 s. We found weak but significant correlation between the times to the minimum of type 1 SRI trends and the lipid spreading time (r = 0.540, p = 0.021).The minimum of the SRI index occurred before the stoppage of superficial lipid layer’s motion. Conclusion: Relatively long lipid layer spreading time was observed suggesting that the tear film build‐up process did not finish completely at the end of the initial rapid tear film alteration phase. The detected initial decrease of the SRI after blink related to the post‐blink tear film motion. This initial pattern is characteristic of the majority of the normal population in spite of the post‐blink alteration pattern of the topographical SAI or corneal aberrations. The SRI seems to be the most useful indirect topographical parameter of the tear film dynamics.     

干眼患者基于泪膜动态变化的图像特征分析

目的:探讨干眼患者角膜荧光素染色后泪膜破裂动态变化和泪膜脂质层动态变化的图像特征及其对干眼的诊断价值。方法:前瞻性研究。选取我院2019-09/2020-12收治的干眼患者66例132眼,根据荧光素染色后泪膜破裂形态的不同分为片状破裂组(17例28眼)、类圆形破裂组(20例27眼)、线状破裂组(25例28眼)、点状破裂组(21例24眼)和不规则破裂组(20例25眼),比较各组患者泪膜破裂动态变化图像特征、泪膜脂质层动态变化图像特征及泪膜首次破裂时间(NIBUTf)、泪膜平均破裂时间(NIBUTav)、泪河高度(TMH)、角膜荧光素染色(FL)评分的差异。结果:各组患者NIBUTf有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(7.56±1.54s vs 8.02±1.86s,P=0.881),其余各组两两比较均有差异(P<0.05)。各组间NIBUTav有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(9.54±2.12s vs 9.73±1.94s,P=0.997),其余各组两两比较均有差异(P<0.05)。各组间TMH比较有差异(P...     

Two-dimensional order in mammalian pre-ocular tear film

We report a grazing incidence x-ray diffraction (GIXD) investigation of the surface lipid layer of the pre-ocular tear film. For the first time we demonstrate the existence of 2D order over a wide range of surface pressures in this system, with typical spicing of 3.75A and 4.16A independent of the monolayer surface pressure. Analogous lipid ordering is also found in an artificial lipid mixture of the major lipid components of the tear film, suggesting that the 2D ordering is set by generic lipid-lipid interactions. Fluorescence microscopy of the natural and artificial tear film mixture reveals the co-existence of a dilute and a much more condensed phase in the amphiphilic lipid matrix over the pressure range of 15-45mN/m investigated by GIXD, plus an additional structure due to the much more hydrophobic part of the mixture. This evidence supports the previous hypothesis that tear film has a layered structure.     

戴软接触镜对泪膜的影响研究

目的：前瞻性设计、研究软镜配戴对泪液和泪膜的影响,以及软镜本身的脱水变化,探讨软镜配戴与干眼发生的关系。方法：８０名眼前表面健康自愿者参加该研究,检测项目有：①四种不同含水量和厚度软镜配戴的脱水变化;②软镜对泪膜形态的改变;③泪膜状况对软镜配戴后的脱水状况的影响 结果：①软镜配戴后均发生镜片脱水现象,脱水过程主要发生在第５～１０分钟,镜原含水量高,则脱有明显,镜片薄,脱水量亦高;②配戴软镜后,泪膜     

睑板下注射曲安奈德改善活动期春季角结膜炎患者眼表症状的临床研究

目的 对比观察春季角结膜炎活动期患者睑板下注射曲安奈德后的眼表症状、泪膜及泪液蛋白的特点.方法 收集2010年8月至2014年6月眼科门诊确诊为春季角结膜炎活动期患者20例(24眼),随机分为A、B两组(各12眼),A组行睑板下注射曲安奈德(每次20 mg,共注射1次),B组行妥布霉素地塞米松眼液滴眼,每天3次,连续1个月.分别对两组患者治疗前与治疗后2周、1个月眼表症状评分、泪膜四项检查及泪液各蛋白测定结果并进行对比.结果 两组患者治疗前眼表症状评分、泪膜四项(泪膜破裂时间、基础泪液分泌试验、泪河高度降低及角膜荧光素染色)、泪液蛋白、乳铁蛋白、溶菌酶比较,差异均无统计学意义(均为P＞0.05);治疗14 d后,A组患者干眼症状眼数增多,眼表指数增高、泪膜破裂时间减短、基础泪液分泌试验增高、泪河高度降低、角膜荧光素染色增强,总蛋白、乳铁蛋白、溶菌酶较B组均明显降低,且差异均有统计学意义(均为P＜0.05).治疗1个月后,A组患者眼表指数、泪膜破裂时间、基础泪液分泌、泪河高度均减少,角膜荧光素染色增强,而B组患者眼表指数、泪膜破裂时间、基础泪液分泌、泪河高度及角膜荧光素染色均降低,差异均有统计学意义(均为P ＜0.05),并且A组较B组眼表指数减少,泪膜破裂时间、基础泪液分泌、泪河高度、角膜荧光素染色均明显增加(P＜0.05).结论 曲安奈德睑板下注射治疗能提高春季角结膜炎活动期患者泪膜稳定性,升高泪液蛋白含量.     

Interactions of polar lipids with cholesteryl ester multilayers elucidate tear film lipid layer structure

PurposeThe tear film lipid layer (TFLL) covers the tear film, stabilizing it and providing a protective barrier against the environment. The TFLL is divided into polar and non-polar sublayers, but the interplay between lipid classes in these sublayers and the structure-function relationship of the TFLL remains poorly characterized. This study aims to provide insight into TFLL function by elucidating the interactions between polar and non-polar TFLL lipids at the molecular level.MethodsMixed films of polar O-acyl-ω-hydroxy fatty acids (OAHFA) or phospholipids and non-polar cholesteryl esters (CE) were used as a model of the TFLL. The organization of the films was studied by using a combination of Brewster angle and fluorescence microscopy in a Langmuir trough system. In addition, the evaporation resistance of the lipid films was evaluated.ResultsPhospholipids and OAHFAs induced the formation of a stable multilamellar CE film. The formation of this film was driven by the interdigitation of acyl chains between the monolayer of polar lipids and the CE multilayer lamellae. Surprisingly, the multilayer structure was destabilized by both low and high concentrations of polar lipids. In addition, the CE multilayer was no more effective in resisting the evaporation of water than a polar lipid monolayer.ConclusionsFormation of multilamellar films by major tear film lipids suggest that the TFLL may have a similar structure. Moreover, in contrast to the current understanding, polar TFLL lipids may not mainly act by stabilizing the non-polar TFLL sublayer, but through a direct evaporation resistant effect.     

The effect of vertical gaze position on ocular tear film stability

Background: An enlarged exposed ocular surface area is known to degrade tear film stability. Little is known of how tear film stability alters with vertical gaze and the change of palpebral fissure height Methods: Tear film break‐up time (TBUT; fluorescent dye) and palpebral fissure height were measured in three vertical gaze positions (primary position and 20 degrees up and 20 degrees down) on 23 healthy volunteers. The effect of gaze direction on TBUT was analysed by ANOVA. Results: Gaze had a significant influence on tear film stability [F(2,44) = 27.6, p < 0.001]. In up‐gaze with an enlarged palpebral fissure height (11.1 ± 1.4 mm), TBUT was degraded (17.3 ± 12.7 seconds). In down‐gaze and decreased palpebral fissure height (6.7 ± 1.2 mm) TBUT was extended (43.5 ± 35.4 seconds). Conclusion: Ocular tear film stability alters with vertical gaze. Our hypothesis is that the change of the palpebral fissure height and the exposed ocular surface area alters the thickness of the lipid layer and with it tear film evaporation.     

办公室干眼泪膜脂质层形态分析

目的应用Keeler泪膜镜评估办公室干眼泪膜脂质层形态的变化,并分析泪膜脂质层与其他干眼检测方法之间的相关性。方法横断面研究。本研究共纳入61例办公室工作人员（干眼患者33例,正常者28例）。所有受检者采用随机数字表法选择一眼按照以下顺序进行检查：干眼症状问卷表（OSDI）、泪新月容量、泪膜脂质层形态、非侵入性泪膜破裂时间、荧光素泪膜破裂时间、角膜荧光素染色以及Schirmer I试验。独立样本t检验或Mann-Whitney U检验用于比较2组间参数,Spearman相关用于分析脂质层厚度等级与其他参数的相关性。结果办公室干眼组脂质层[2（1~3）]较正常组[3（3~4）]薄（U=250,P<0.01）。在诊断办公室干眼时,脂质层厚度等级的最优诊断敏感性（0.545）和特异性（0.857）截断值为2级。脂质层厚度等级与非侵入性泪膜破裂时间和总泪新月容量呈正相关（r=0.485、0.349,P<0.05）,而与症状及其他检测方法不相关。结论Keeler泪膜镜可以有效评估办公室干眼泪膜脂质层厚度。泪膜脂质层厚度与泪新月容量、泪膜稳定性相关。     

泪膜破裂时间与血压、血糖、血脂水平的相关性研究

目的：分析泪膜破裂时间(break-up time,BUT)与全身因素的关系。

方法：收集2015-01/2016-07于福州总医院体检中心的体检者或住院患者共747例747眼,所有纳入研究者均测量收缩压、舒张压、血糖、总胆固醇、高密度脂蛋白、低密度脂蛋白、BUT等值。采用SPSS19.0对BUT与全身因素的关系进行简单及多重线性回归分析。

结果：简单线性回归分析结果可见,舒张压与BUT呈正相关(P<0.05),年龄、收缩压、血糖、胆固醇、高密度脂蛋白、低密度脂蛋白与BUT呈负相关(P<0.05),而甘油三酯与BUT无相关性(P=0.227)。多重线性回归分析提示,BUT与舒张压(P<0.001)呈正相关,而与收缩压(P<0.001)、血糖(P<0.001)、高度密度脂蛋白(P=0.019)呈负相关。BUT与年龄、胆固醇、甘油三酯、低密度脂蛋白无相关性。

结论：在所有参与研究的指标中,血糖与BUT的相关性最为显著,提示在临床研究中糖尿病患者的眼表损害。     

Keratograph 5M眼表综合分析仪观察飞秒激光制瓣LASIK手术对泪膜和睑板腺的影响

目的　使用Ｋｅｒａｔｏｇｒａｐｈ５Ｍ眼表综合分析仪观察准分子激光原位角膜磨镶术（ｌａｓｅｒｉｎｓｉｔｕｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）对泪膜和睑板腺的影响。方法　选取近视眼患者６５例（１３０眼）,均行飞秒激光制瓣ＬＡＳＩＫ手术。于ＬＡＳＩＫ术前及术后１周、１个月、６个月检查患者,检查项目包括:干眼症状评分、泪膜破裂时间（ｔｅａｒｂｒｅａｋｕｐｔｉｍｅ,ＴＢＵＴ）、角膜荧光素钠染色,采用Ｋｅｒａｔｏ-ｇｒａｐｈ５Ｍ眼表综合分析仪检查非侵入性泪膜破裂时间（ｎｏｎ-ｉｎｖａｓｉｖｅｂｒｅａｋｕｐｔｉｍｅ,ＮＩＴＢＵＴ）、非侵入性泪河高度（ｎｏｎ-ｉｎｖａｓｉｖｅｔｅａｒｍｅｎｉｓｃｕｓｈｅｉｇｈｔ,ＮＩＴＭＨ）。睑板腺检查项目有睑缘评分,采用Ｋｅｒａｔｏｇｒａｐｈ５Ｍ眼表综合分析仪检查脂质层厚度分级,睑板腺现存面积比。分析ＴＢＵＴ、ＮＩＴＢＵＴ（ｆ）（首次）和ＮＩＴＢＵＴ（ａｖ）（平均）之间的相关性。结果　与术前相比,术后１周、１个月干眼症状评分均升高（均为Ｐ＜０．０５）;术后１周、１个月ＴＢＵＴ分别为（７．００±２．１７）ｓ、（７．２１±２．１５）ｓ,与术前（１５．００±５．０１）ｓ相比,差异均有统计学意义（均为Ｐ＜０．０５）;术后１周、１个月ＮＩＴＢＵＴ（ｆ）分别为（５．４８±２．０８）ｓ、（５．６３±１．９２）ｓ,与术前（１１．４４±５．００）ｓ相比,差异均有统计学意义（均为Ｐ＜０．０５）;术后１周、１个月ＮＩＴＢＵＴ（ａｖ）分别为（９．０４±２．８０）ｓ、（８．９４±２．４６）ｓ,较术前（１３．７９±４．００）ｓ缩短（均为Ｐ＜０．０５）;角膜荧光素钠染色评分和ＮＩＴＭＨ结果与术前比较,差异均无统计学意义（均为Ｐ＞０．０５）;术后１周、１个月睑板腺脂质层厚度较术前变薄,差异均有统计学意义（均为Ｐ＜０．０５）;睑缘评分及睑板腺现存面积比与术前比较,差异均无统计学意义（均为Ｐ＞０．０５）。术后６个月各项检查结果与术前相比差异均无统计学意义（均为Ｐ＞０．０５）。术后各时间所测ＮＩＴＢＵＴ（ｆ）比ＮＩＴＢＵＴ（ａｖ）短。ＮＩＴＢＵＴ（ｆ）与ＮＩＴＢＵＴ（ａｖ）、ＮＩＴＢＵＴ（ｆ）与ＴＢＵＴ、ＮＩＴＢＵＴ（ａｖ）与ＴＢＵＴ均呈正相关性（ｒ＝０．６５,Ｐ＜０．００１;ｒ＝０．３６,Ｐ＝０．０２５;ｒ＝０．３８,Ｐ＝０．０２８）。结论　Ｋｅｒａｔｏｇｒａｐｈ５Ｍ眼表综合分析仪作为非侵入性检测仪器可以快速、客观地评估泪膜的功能和睑板腺的状态,为干眼的诊断以及睑板腺功能的评估提供了参考依据。ＬＡＳＩＫ术后患者短期内会发生干眼或原有干眼不同程度加重,但术后０．５ａ大部分患者的ＴＢＵＴ和泪河高度可恢复到术前水平,且未观察到ＬＡＳＩＫ手术对睑板腺的不良影响。