摘要目的 使用非接触式红外线睑板腺观察仪观察睑板腺功能障碍(MGD)患者治疗前后睑板腺形态的变化.方法 选取2014年3月至2015年6月于山西省眼科医院门诊就诊的54例(62只眼)睑板腺功能障碍患者,分别于治疗前、治疗后4周在裂隙灯下行眼前节检查、泪液分泌试验(SIt)、泪膜破裂时间(BUT)、角膜荧光索染色评分、泪膜形态分级,采用非接触式红外线睑板腺摄像仪行睑板腺腺体缺失分级.对治疗前后MGD患者干眼各项指标及睑板腺腺体变化进行对照分析.结果 MGD患者的泪膜影像分级及BUT变化明显,治疗前后差异有统计学意义(P =0.032;P=0.01);睑板腺腺体缺失分级在治疗后所降低,但与治疗前相比差异无统计学意义(t =0.068,P=0.716),睑板腺脂质排出情况及睑板腺分泌物性状均较治疗前有改善,差异有统计学意义(t =2.02,P=0.04;t=2.56,P=0.01);角膜荧光染色和Schirmer Ⅰ的实验数据在治疗前后差异无统计学意义(t=0.15,P=0.19;t=0.58,P =0.57).结论 MGD可引起蒸发过强型干眼,干眼患者中睑板腺异常比例高达65％,应及早对眼部进行综合治疗,从而达到治疗干眼症的目的.非接触式红外线睑板腺观察仪可以有效、快速、无刺激、客观地评价睑板腺形态.

abstractsObjective To observe the changes of meibomian morphology after treatment using non-contact infrared meibography.Methods Prospective case control study.Fifty-four MGD patients (62 eyes) from Shanxi Eye Hospital outpatient department were enrolled in this study according to the PPP.All patients were subjected to the slip-lamp,Schirmer's Test Ⅰ,corneal fluorescein staining,the no-invasive tear film break-up time (NIBUT),DR-Ⅰ Tearscope Plus and infrared meibography before and after treatment respectively.The various parameters of dry eye and the changes of meibomian glands were compared.Results After treatment,the NTBUT and tear interferometry exhibited significantly improved,as compared to these before treatment (P =0.01;P =0.032).Meibomian gland morphology,corneal fluorescein staining and Schirmer's Test Ⅰ were improved after treatment but the differences were not statistically significant (t =0.068,P =0.716;t=0.15 P =0.19;t =0.06,P =0.08).Slip-lamp revealed the significant progressive changes of glandular secretion and characters (t =2.02,P =0.04;t =2.56,P =0.01).Conclusions MGD should be treated timely and comprehensively in order to decrease the symbols of dry eyes.The non-contact infrared meibography system is useful for obtaining information on the meibomian gland structure,not only effective,real-time but objective.