使用Oculus Keratograph 5M测量圆锥角膜患者NITBUT和TMH

目的:比较圆锥角膜患者和正常人使用Oculus Keratograph 5M(K5M)测得的非侵入性泪膜破裂时间(NITBUT)和泪河高度(TMH),以确定这两项指标和圆锥角膜的关系.方法:50例100眼圆锥角膜患者和50例100眼正常人参加了这项研究.圆锥角膜组患者的年龄为15~60(平均28.33±8.60)y.对照组为18~60(平均26.25±1.11)岁.使用K5M测量所有受试者的NITBUT和TMH.结果:两组之间的NITBUT和TMH平均值差异无统计学意义(P=0.58,0.69).两参数的相关性研究显示,两组中NITBUT和TMH之间均无相关性(圆锥角膜组: r=0.053, P=0.721;对照组: r=-0.0501, P=0.7098).结论:研究显示圆锥角膜对泪液质量和数量都没有显著的临床影响.     

强迫睁眼对健康人群非侵入性泪膜破裂时间的影响

目的：观察健康人群强迫睁眼前后Oculus 眼表综合分析仪所测非侵入性泪膜破裂时间和干眼分级有无差异。

方法：前瞻性病例自身对照研究。40例志愿者接受此项检查,分别于强迫睁眼前后行Oculus眼表综合分析仪非侵入性首次泪膜破裂时间(non-invasive first tear film break-up time,NIBUT_f)和非侵入性平均泪膜破裂时间(non-invasive average tear film break-up time,NIBUT_av)检查,仪器自动进行干眼分级。首次检查先右眼后左眼,第二次检查先左眼后右眼。

结果：首次检查眼(即强迫睁眼前)NIBUT_f均值为9.18±5.52s、 NIBUT_av均值为11.74±5.59s,干眼各级所占百分比分别为 43%、37%、20%; 第二检查眼(强迫睁眼后)NIBUT_f均值为8.91±5.54s, NIBUT_av均值为11.76±5.58s, 干眼各级所占百分比分别为 35%、48%、16%。健康人群强迫睁眼前后双眼NIBUT_f 、NIBUT_av和干眼分级比较,差异无统计学意义(t=0.37,P=0.72; t=-0.038,P=0.97; Z=-0.42,P=0.68)。

结论：健康人群强迫睁眼前后眼表综合分析仪所测非侵入性泪膜破裂时间和干眼分级无影响。     

The influence of religious fasting on basal tear secretion and tear break-up time

Muslims abstain from food and drink from dawn to sunset during the holy month of Ramadan. An extended strict fasting may influence tear secretion and quality. We investigated changes in basal tear secretion (BTS) and tear break-up time (BUT) at the beginning and at the end of fasting on 32 healthy male patients with a mean age of 22.3 ± 2.9 years. Body weight and urine specific gravity were also determined to assess the extent of dehydration due to fasting. Each case lost 0.1–1.25 kg of body weight while urine specific gravity changes were statistically insignificant. Mean BTS amount was 19.9 ± 10.9 mm at the initial examination and 19.7 ± 11.5 mm at the end of fasting (p=0.9). BUT values were 20.1 ± 9.3 sec at the beginning of fasting and 23.5 ± 14.9 sec at the end of fasting (p=0.19). We found that religious fasting in the winter season does not seem to affect BTS and BUT values in healthy individuals. This revised version was published online in July 2006 with corrections to the Cover Date.     

Effect of reading on non-invasive tear break-up time and inter-blink interval

The authors investigated the effect of reading both Chinese and English articles on the non-invasive tear film break-up time and inter-blink interval of 33 Hong Kong-Chinese subjects. There were no significant differences in the non-invasive tear break-up time or the inter-blink interval between reading a Chinese article and reading an English one. Reading had no effect on the non-invasive tear break-up time, but there was a significant increase in the inter-blink interval when reading. Reduced blinking is a probable cause of symptoms of discomfort and gritty eyes during prolonged reading. There were significant correlations between non-invasive tear break-up time and inter-blink interval before reading and when reading the Chinese article, but not when reading the English article. However, these results were due to one group of subjects only.     

两种角膜屈光手术方式手术前后泪液功能变化的比较

目的 比较不同角膜屈光手术方式对泪液功能指标的影响。设计 回顾性比较性病例系列。研究对象 42例接受角膜屈光手术并随访6个月的近视患者,其中LASIK组20例,前弹力层下角膜磨镶术（SBK）组22例。方法 对两组患者分别于术前,术后10天,1、3和6个月用Oculus眼表综合分析仪行非侵入性首次泪膜破裂时间（NIBUTf）、非侵入性平均泪膜破裂时间（NIBUTa）、下泪河高度（LTMH）检查,均取右眼资料进行分析,比较两组间不同时间各指标差异,及组内不同时间各指标差异。主要指标 NIBUTf、NIBUTa、LTMH。结果 两组NIBUTf和LTMH在各个时间点均无统计学差异（P均>0.05）;术后3个月SBK组NIBUTa比LASIK组升高（P=0.02）,其余时间点均无统计学差异（P均>0.05）。LASIK组NIBUTf术后1、3个月与术前相比降低（P均<0.05）,与术后10天、术后6个月比较无明显差异（P均>0.05）;NIBUTa、LTMH术后各时间点比术前均降低,但差异均无统计学意义（P均>0.05）。SBK组NIBUTf术后10天,1、3个月与术前相比均降低（P均<0.05）,术后6个月与术前相比降低,但无统计学差异（P=0.14）; NIBUTa术后10天比术前降低（P=0.04）,术后1、3个月比术前降低,但无统计学差异（P均>0.05）;LTMH术前与术后各时间点差异均无统计学意义（P均>0.05）。结论 两种角膜屈光手术术后早期NIBUTf 和NIBUTa均较术前降低,术后6个月恢复至术前水平。术后3个月SBK组NIBUTa比LASIK组升高,SBK组比LASIK组泪膜功能恢复快。（眼科,2018,  27：117-121）     

Topographic tear film trend and new parameters for non-invasive break up time test

AIM: To evaluate the quantitative and qualitative results of the noninvasive tear film break-up time (NI-BUT) test and investigate the predictive ability of the new NI-BUT parameter in discriminating between normal Ocular Surface Disease Index (OSDI; scores ≤12) and abnormal OSDI (scores ≥13). METHODS: A total of 341 eyes of 341 volunteers who applied for routine eye outpatient control were included in the prospective study. All participants’ noninvasive first tear film break-up time (NIF-BUT), noninvasive average tear film break-up time (NIAvg-BUT) and average value of the first three break-up time (A3F-BUT) were analyzed. A3F-BUT, the new NI-BUT parameter, is calculated by adding the NIF-BUT value to the 2nd break-up time value that has a difference of at most 1 second from the NIF-BUT value and to the 3rd break-up time and then dividing the respective sum by 3. Receiver operating characteristic (ROC) curve and forward logistic regression analyses were performed to determine the parameter that had the best predictive ability between the OSDI groups. RESULTS: The NI-BUT values of 255 eyes of 255 volunteers included in the study were analyzed statistically. The mean NIF-BUT, NIAvg-BUT, and A3F-BUT values were calculated as 5.3±3.0, 8±3.1, and 5.8±3.0 seconds, respectively. All three parameters were found to be significantly lower in the abnormal OSDI group (P=0.014, 0.034, and 0.011, respectively). The area under the curve (AUC) of the A3F-BUT to predict abnormal OSDI was AUC=0.625 (0.529-0.720), P=0.011 and NIF-BUT was AUC=0.599 (0.502-0.696), P=0.043. The A3F-BUT parameter and NIF-BUT parameters were found to be significantly efficient in discriminating abnormal OSDI. CONCLUSION: The new parameter for the NI-BUT test has more predictive ability in the discrimination of OSDI groups.     

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。     

Stability of the precorneal tear film: a review

Numerous studies have been done on the tear physiology and stability of the precorneal tear film and various hypotheses explaining the mechanism of tear rupture and formation have been proposed. One hypothesis proposed that the film stability was caused by the spreading of mucin along the lipid-aqueous interface which increases the film pressure. As the lipid starts diffusing into the mucus-tear interface, and once the hydrophilicity of the mucus is overwhelmed, the tear film will rupture over the hydrophobic spots. Another hypothesis however, attributes the rupture of the mucous layer, due to van der Waals forces between the epithelium and the mucin, as the cause of tear instability. However, the actual composition of the interfaces between each layer of the precorneal tear film remains unclear and the exact mechanism of the tear film rupture is difficult to pinpoint. This review surveys the literature and summarises current opinions in this field.     

Oculus眼表综合分析仪测量LASIK术后干眼患者非侵入性泪液功能指标与干眼症状和体征之间的相关性分析

目的　探讨Ｏｃｕｌｕｓ眼表综合分析仪测量准分子激光原位角膜磨镶术（ｌａｓｅｒｉｎｓｉ-ｔｕｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）术后干眼患者的非侵入性泪液功能指标与干眼症状、体征的相关性。方法　选择鄂州市中心医院２０１４年９月至１２月行ＬＡＳＩＫ且术后１个月被诊断为干眼的患者４０例（４０眼）,Ｏｃｕｌｕｓ眼表综合分析仪测量非侵入性首次泪膜破裂时间（ｎｏｎ-ｉｎｖａｓｉｖｅｆｉｒｓｔｔｅａｒｆｉｌｍｂｒｅａｋ-ｕｐｔｉｍｅ,ＮＩＢ-ＵＴｆ）、非侵入性平均泪膜破裂时间（ｎｏｎ-ｉｎｖａｓｉｖｅａｖｅｒａｇｅｔｅａｒｆｉｌｍｂｒｅａｋ-ｕｐｔｉｍｅ,ＮＩＢＵＴａｖ）、Ｏｃｕｌｕｓ自动干眼分级、下泪河高度（ｌｏｗｅｒｔｅａｒｍｅｎｉｓｃｕｓｈｉｇｈｔ,ＬＴＭＨ）;基础泪液分泌（ＳｃｈｉｒｍｅｒⅠ Ｔｅｓｔ,ＳⅠＴ）、角膜荧光素染色（ｃｏｒｎｅａｌｆｌｕｏｒｅｓｃｅｉｎｓｔａｉｎｉｎｇ,ＣＦＳ）评分、患者干眼主观症状评分。采用Ｓｐｅａｒｍａｎ秩相关分析ＮＩＢＵＴｆ、ＮＩＢＵＴａｖ、Ｏｃｕｌｕｓ自动干眼分级、ＬＴＭＨ与ＳⅠＴ、ＦＳ、干眼主观症状评分之间的关系。结果　ＮＩＢＵＴｆ、ＮＩＢＵＴａｖ与Ｏｃｕｌｕｓ自动干眼分级均呈负相关（ｒ＝－０．４３０,Ｐ＝０．００６;ｒ＝－０．７４７,Ｐ＝０．０００）;ＳⅠＴ与ＮＩＢＵＴｆ、ＮＩＢＵＴａｖ、ＬＴＭＨ均呈正相关（ｒ＝０．４５９,Ｐ＝０．００３;ｒ＝０．３９４,Ｐ＝０．０１２;ｒ＝０．７３３,Ｐ＝０．０００）,ＳⅠＴ与Ｏｃｕｌｕｓ自动干眼分级无相关性（ｒ＝－０．２５９,Ｐ＝０．１０７）;ＣＦＳ评分与ＮＩＢＵＴａｖ、ＬＴＭＨ均呈负相关（ｒ＝－０．４６６,Ｐ＝０．００２;ｒ＝－０．６８７,Ｐ＝０．０００）,ＣＦＳ评分与ＮＩＢＵＴｆ、Ｏｃｕｌｕｓ自动干眼分级均无相关性（ｒ＝－０．１８９,Ｐ＝０．２４４;ｒ＝０．３０１,Ｐ＝０．０５９）;干眼主观症状评分与ＮＩＢＵＴｆ、ＮＩＢＵＴａｖ均呈负相关（ｒ＝－０．５３０,Ｐ＝０．０００;ｒ＝－０．７００,Ｐ＝０．０００）,与Ｏｃｕｌｕｓ自动干眼分级呈正相关（ｒ＝０．６２３,Ｐ＝０．０００）、与ＬＴＭＨ无明显相关性（ｒ＝－０．２４３,Ｐ＝０．１３０）。结论　Ｏｃｕｌｕｓ眼表综合分析仪能客观地测量非侵入性泪液功能指标,与干眼其他指标存在相关性,可作为辅助ＬＡＳＩＫ术后干眼诊断和随访的有效工具。     

Corneal hyperalgesia in patients with short tear film break-up time dry eye

PurposeTo evaluate corneal tactile and pain sensations in patients with short tear film break-up time dry eye (sBUT DE).MethodsThis study enrolled 60 patients with sBUT DE and 46 healthy volunteers from Japan. We evaluated corneal tactile and pain sensations using a modified method with the Cochet-Bonnet corneal esthesiometer.ResultsPatients with sBUT DE had higher corneal pain sensitivity (26.3 ± 23.1 mm) than healthy subjects (6.9 ± 16.4 mm), but similar corneal tactile sensation (52.0 ± 15.5 mm and 52.9 ± 14.9 mm, respectively). In patients with sBUT DE and corneal hyperalgesia (n = 22, 36.7%), defined as a pain sensitivity ≥40 mm (i.e., the cutoff value at the 95th percentile of corneal pain sensitivity in healthy subjects), a strong significant correlation was found between the subjective pain score and objective corneal pain sensation (R = 0.79). However, for the entire cohort, we found a weak positive correlation between the subjective pain score and objective corneal pain sensation.ConclusionsPatients with sBUT DE were hypersensitive to corneal pain, which suggested that corneal hyperalgesia partly accounted for subjective symptoms in patients with sBUT DE.     

Mechanical manipulation of the lids and tear break-up time measurements in Hong Kong Chinese

We measured tear break-up time (TBUT) after lid-rubbing in a single masked experiment, and found that TBUT was unaltered. A further single masked experiment in which non-invasive tear break-up Lime (NITBUT) was measured after the lids were raised as if to apply fluorescent also showed no effect of this interference with the lids. An experiment in which fluorescent was applied either with the lid raised or not raised during fluorescein application, again with the experimenter masked with respect to treatment, also produced no significant difference in TBUT. When we measured TBUT with the lid raised so that it was not in contact with the cornea, there was no difference in TBUT for the group between the "lifted" and 'non-lifted' eye; some subjects showed substantially shorter TBUT values, while others showed substantially longer TBUT values. These findings are surprising in view of the concerns expressed in the literature regarding the sensitivity of the tear film to mechanical interference, and suggest that the tear film is more resistant to disruption than has previously been thought.     

马来、中国、印度和尼日利亚四个不同国家人群的泪膜测量分析

目的:比较马来、中国、印度和尼日利亚4个不同人群的无创性泪膜破裂时间(NIBUT)、泪膜破裂时间(TBUT)、基础泪液分泌量(BTS)和眨眼频率。方法:共纳入120例(男性61例,女性59例)年龄20~39岁健康受试者,其中30例马来人,30例中国人,31例印度人,29例尼日利亚人。根据McMonnies调查问卷和临床检查,挑选了健康受试者。选取受试者右眼评估NIBUT、TBUT、BTS,及眨眼频率。结果:四组人群中NIBUT、TBUT、BTS,及眨眼频率具有显著差异(P=0.018,P=0.001,P=0.011,P=0.004)。不同民族人群性别间NIBUT、TBUT、BTS和眨眼频率差异无统计学意义。相较于其他三组,印度人NIBUT(10±6s),TBUT(7±5s)和BTS(20±20 mm)中位数较高,中国人NIBUT(7.5±4s)和TBUT(4±2s)中位数较低,马来人BTS为9.5±16mm。眨眼频率与NIBUT、TBUT、BTS间无显著相关(r=-0.119,P=0.195),(r=-0.086,P=0.352),(r=-0.123,P=0.180)。结论:研究体现了四个不同国家人群间泪膜测量值的差异性。     

Relationship between goblet cell density and tear function tests

AIM: The objective of this study was to find a relationship between goblet cell density (GCD) and other diagnostic tests of dry eye in a group of normal healthy Chinese subjects. The capability of using GCD as a tear function test was assessed. METHOD: A total of 42 optometry students with no contact lens wear history were recruited. Subjects were required to fill in a dry eye questionnaire. The non-invasive tear break-up time (NITBUT) of each subject was measured, followed by phenol red thread test (PRTT) and tear break-up time (TBUT) tests. Conjunctival epithelial cells from the inferior nasal bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS (Periodic Acid Schiff)-haematoxylin. The goblet cells and the conjunctival epithelial cells were counted under a light microscope of 100x magnification. Spearman's rho (rho) correlation test was used to analyse the relationship between GCD and the other tear function tests. RESULTS: With a probability level of 0.0051 (corrected for a cumulative familywise error rate of p = 0.05), GCD was found to have no correlation with NITBUT (rho = -0.193, p = 0.222), McMonnies Dry Eye Scores (MCDES) (rho = -0.052, p = 0.742), PRTT (rho = - 0.188, p = 0.234) and TBUT (rho = 0.246, p = 0.117). CONCLUSION: There was no correlation between GCD and MCDES, NITBUT, PRTT and TBUT. The GCD alone is not a useful diagnostic test for tear film instability in normal eyes although it is a good indicator in the diagnosis of ocular surface diseases.     

Reliability of the tear break-up time technique of assessing tear stability and the locations of the tear break-up in Hong Kong Chinese.

The measurement of tear break-up time (TBUT) in assessing stability of the tear film is somewhat controversial, even though the technique is widely used. We examined reliability of the technique within and among examiners and conclude that measurements of TBUT can be made reliably; full-beam observation of the cornea is preferable to scanning the cornea with a narrow slit in making the measurements. There may be differences in TBUT measurements made in the same subjects among examiners, but these differences are smaller with more experienced practitioners. In the Hong Kong Chinese (HK-Chinese), tear break-up appears to be more likely to first occur in the inferior periphery of the cornea. In this population mean TBUT is about 7.20 s; assuming a Gaussian distribution of TBUT values, 2.1 s should be adopted as the lower limit for normal TBUT in HK-Chinese.     

糖尿病短泪膜破裂时间型干眼患者的症状和体征分析

目的　探讨糖尿病与非糖尿病患者中短泪膜破裂时间型（short tear break-up time，sBUT）干眼患者之间眼表状况的不同。方法　收集50~80岁的糖尿病患者59例（118眼），非糖尿病患者41例（82眼），排除泪液缺乏型干眼患者，用标准干眼评估问卷（standard patient evaluation of eye dryness，SPEED）评分，泪液分泌量，非侵入性泪膜第一秒破裂（BUT1st）和平均破裂时间（BUTavg），睑板腺拍照评分，脂质层厚度(lipid layer thickness，LLT)，眨眼频率进行统计分析，进一步分为sBUT干眼患者（糖尿病sBUT组、非糖尿病sBUT组）和非sBUT干眼患者（糖尿病非sBUT组、非糖尿病非sBUT组）后再进行统计分析。结果　相比于非糖尿病组，糖尿病组有更高的SPEED评分和睑板腺拍照评分，更薄的LLT，差异均有统计学意义（均为P<0.05）。糖尿病sBUT组的SPEED评分为（7.40±3.24）分，睑板腺拍照评分为（3.2±1.16）分，眨眼频率（6.78±5.10）次，在4组中最高；而Schirmer值［（5.80±4.74）mm］、BUT1st值［（3.44±1.10）s］、BUTavg值［（5.74±3.17）s］和LLT［（66.40±23.34）nm］在4组中最低。在泪液相对不缺乏的干眼人群中，LLT分别与眨眼频率、SPEED评分之间呈负相关（r=-0.168，P<0.05；r=-0.298，P<0.001）；眨眼频率与SPEED评分呈正相关（r=0.268，P<0.001）。结论　糖尿病患者睑板腺的短缩和缺失更严重，使LLT变更薄，从而引起泪膜破裂时间变更短，眨眼频率更高，导致糖尿病患者的干眼症状相比于非糖尿病患者更重。     

Keratograph眼表综合分析仪与传统方法对泪膜功能评价的一致性分析

目的：探讨一种最新的眼表综合分析仪Keratograph对于泪膜稳定性评估的重复性和准确性,将其测量值与传统的检查方法进行比较。

方法：采用Keratograph测量包括首次泪膜破裂时间(the first tear film break-up time, BUT-f)和平均泪膜破裂时间(the average tear film break-up time, BUT-ave)在内的非侵入式泪膜破裂时间(noninvasive tear film break-up time, NI_BUT)结果。测量结果的重复性使用变异系数(coefficient of variation,CV)和组内相关系数(intraclass correlation coefficient,ICC)进行评价, NI-BUT与传统的荧光素泪膜破裂时间(fluorescein tear film break-up time, FBUT)的比较采用Wilcoxon符号秩和检验,确定NI-BUT与FBUT,Schirmer Ⅰ试验结果的相关关系,采用Bland-Altman分析进行一致性评价。

结果：本研究纳入了48个受检者(48眼),平均年龄38.7±15.2岁。BUT-f的CV和ICC分别为12.6%和0.95,BUT-ave的为9.8%和0.96。BUT-f值低于FBUT值,差异有统计学意义(6.16±2.46s vs 7.46±1.92s, P < 0.01)。NI-BUT与FBUT,Schirmer Ⅰ试验结果之间存在显著的正相关关系(P<0.01)。BUT-f与FBUT的95%一致性界限(limits of agreement, LoA)范围为4.46s,BUT-ave与FBUT的LoA范围为3.64s。

结论：Keratograph能够提供具有较好重复性和可靠性的NI-BUT数据,在干眼诊治和角膜屈光性手术等领域有很好的应用前景。     

单侧翼状胬肉患者50例泪液功能的改变(英文)

目的:检测泪液功能试验(SchirmerⅠtest,SⅠt)及泪膜破裂时间(tear filmbreak-up time,TBUT)在翼状胬肉患者中的改变。方法:筛选50例患者(100眼,50例翼状胬肉眼),行SⅠt及TBUT试验。结果:SⅠt试验在翼状胬肉眼的平均值为19.6±11.6 (1 ～40) mm,对照眼为17.2±10.6(1 ～35)mm,翼状胬肉眼中20例(40%)SⅠt试验结果异常,对照眼为21例(42%),其差异无统计学意义(P=075)。两组间差异无统计学意义(t=1.453,P=0.15)。TBUT在翼状胬肉眼及对照眼中分别为7.4±5.1 ( 2 ～20)s, 13.4±6.1 (2 ～25)s,两组间的差异有显著统计学意义(t=8.029,P<0.01)。翼状胬肉眼中TBUT异常的为39眼(78%),对照眼中为16眼(32%);差异有显著统计学意义(P<0.01)。结论:与对照眼相比较,SⅠt试验在翼状胬肉眼中差异无统计学意义,TBUT在翼状胬肉眼中有所下降。     

Tear film measurements in four different ethnic groups: Malay, Chinese, Indian and Nigerian

AIM: To compare the non-invasive tear film break-up time (NIBUT), tear break up time (TBUT), basal tear secretion (BTS) and blink rate in four ethnic groups: Malay, Chinese, Indian and Nigerian. METHODS: Totally 120 healthy (61 males and 59 females) subjects (without dry eye symptoms and ocular surface disorder) with the age 20 to 39 years were recruited; 30 were Malays, 30 were Chinese, 31 were Indians and 29 were Nigerians. Based on McMonnies questionnaire and clinical examination, normal subjects were selected. NIBUT, TBUT, BTS were assessed in only one eye (right) of each subject and blink rate was also assessed. RESULTS: There was significant difference in the NIBUT, TBUT, BTS and blink rate among 4 different ethnic groups (P=0.018, 0.001, 0.011, and 0.004 respectively). No statistically significant difference of NIBUT, TBUT, BTS and blink rate was found between the genders among different ethnic groups. Indian had higher median for NIBUT (10±6s), TBUT (7±5s) and BTS (20±20 mm) than other races. Chinese had lower median for NIBUT (7.5±4s) and TBUT (4±2s) while Malay had for BTS (9.5±16 mm) among the groups. There was no significant correlation of blink rate with NIBUT (r=-0.119, P=0.195), TBUT (r=-0.086, P=0.352), and BTS (r=-0.123, P=0.180) respectively. CONCLUSION: The tear-film measurement values are variability in four ethnic groups.     

角膜地形综合分析仪在干眼诊断中的临床应用

目的　研究角膜地形综合分析仪在干眼诊断中的应用。方法　本研究选择符合干眼症诊断的６２例１１８眼为干眼组,符合正常眼标准的５９例１１４眼为对照组,用角膜地形综合分析仪定量测量首次非侵犯性泪膜破裂时间（ｆｉｒｓｔｎｏｎ-ｉｎｖａｓｉｖｅｔｅａｒｂｒｅａｋ-ｕｐｔｉｍｅ,ｆＮＩＢＵＴ）、平均非侵犯性泪膜破裂时间（ａｖｅｒａｇｅｎｏｎ-ｉｎｖａｓｉｖｅｔｅａｒｂｒｅａｋ-ｕｐｔｉｍｅ,ａＮＩＢＵＴ）、泪河高度、泪膜稳定性分级及泪膜破裂的位置,并进行统计学分析。结果　２０～３９岁年龄段:干眼组、对照组ｆＮＩＢＵＴ分别为（５．５１３±２．５１６）ｓ、（１０．３４９±６．１６４）ｓ;两组ａＮＩＢＵＴ分别为（７．９２７±４．３７４）ｓ、（１６．０５８±５．２４０）ｓ。＞３９～６０岁年龄段:干眼组、对照组ｆＮＩＢＵＴ分别为（５．６８５±４．１８７）ｓ、（１１．４８７±７．１７１）ｓ,ａＮＩＢＵＴ分别为（７．４５８±４．６７１）ｓ、（１６．２８９±５．０９２）ｓ;同一年龄段两组间ｆＮＩＢＵＴ和ａＮＩＢＵＴ差异均有统计学意义（均为Ｐ＜０．０１）。两组间泪膜稳定性分级差异有统计学意义（χ２＝１１６．３３１,Ｐ＝０．０００）。两组间泪河高度正常率差异无统计学意义（χ２＝２．４３７,Ｐ＝０．１１９）。角膜荧光素染色面积最大的象限与泪膜首次破裂点所在象限吻合者４１眼（６５．１％）。结论　利用角膜地形综合分析仪可以定量测量ＮＩＢＵＴ,并能对泪膜稳定性进行客观分级,与传统诊断干眼的方法具有较好的一致性。