眼睑压力测量仪的初步临床应用

目的 采用新型眼睑压力测量仪对正常人和蒸发过强型干眼患者进行上眼睑压力测量，并分析眼睑压力的影响因素。设计 前瞻性病例系列。研究对象 北京同仁医院干眼患者62例，平均年龄（48.31±3.42）岁；正常人对照42例，平均年龄（45.72±5.33）岁。均将右眼纳入研究。方法 设计新型眼睑压力测量仪，测量正常人和蒸发过强型干眼患者的上眼睑压力及干眼指标，分析眼睑压力的影响因素。每位受试者测量3次，观察仪器的准确性和重复性。随访受试者的症状和体征，观察仪器的安全性。主要指标 上眼睑压力。结果 正常受试者和干眼患者的上眼睑压力值分别为（0.40±0.13）牛顿（N）和（0.55±0.21）N（t=2.561，P=0.026）；每位受试者测量3次，每组结果之间的差异无统计学意义（t=1.22，P>0.05）；所有受试者测量后均未出现眼部异常。正常受试者上眼睑压力与年龄呈负相关（r=-0.372，P=0.02）。干眼患者上眼睑压力与BUT、SchirmerⅠ之间呈明显负相关（r=-0.262、-0.235，P<0.05），与角膜染色评分之间未见明显相关（r=0.205，P=0.063）。结论 新型眼睑压力测量仪可安全、有效地检测上眼睑压力。随着年龄的增长，正常人上眼睑施于眼球的压力逐渐下降。与正常人相比，干眼患者眼睑压力升高。 眼睑压力与眼表上皮细胞病变之间的关系尚待进一步研究。

Design and preliminary application of the blepharometer

Objective To measrue the eyelid pressure with the designed blepharometer on normal and dry eye patients, and to analyze the influence factors of eyelid pressure. Design Prospective case series. Participants Forty-two cases of normal subjects and sixty-two cases of dry eye patients in the Beijing Tongren Hospital were collected. Methods The new type of eyelid pressure measurement instrument (blepharometer) was used to measure the pressure of the upper eyelid of normal and dry eye patients, and the influence factors of eyelid pressure were analyzed. For observing the repeatability of the instrument, each subjuct was measured 3 times. The symptoms and signs of the subjects were followed to observe the safety of the instrument. Main Outcome Measures Upper eyelid pressure. Results The upper eyelid pressure value of normal subjects is (0.40±0.13)N, lower than dry eye patients(0.55±0.21 N) (t=2.561, P=0.026). There are no statistical difference between each set of data measured three times (t=1.22, P>0.05) . None of the subjects appeared ocular abnormalities. The upper eyelid pressure was negatively correlated with age (r =-0.372, P=0.020). There was a significant correlation between the upper eyelid pressure and the BUT and Schirmer I test in dry eye patients (r=-0.262、-0.235，P<0.05), and no significant correlation was observed with the corneal staining score (r=0.205，P=0.063). Conclusion The new eyelid pressure instrument can safely, effectively and repeatably evaluate the upper eyelid pressure. With age, the pressure of the upper eyelid to the eyeball gradually decreases in normal subjects. Compared with normals, the eyelid pressure of the dry eye patients was elevated. The relationship between eyelid pressure and ocular surface epithelial cell lesion remains to be further studied.