Dynamic Changes of Tear Fluid After Cosmetic Transcutaneous Lower Blepharoplasty Measured by Optical Coherence Tomography
Dynamic Changes of Tear Fluid After Cosmetic Transcutaneous Lower Blepharoplasty Measured by Optical Coherence Tomography
复制标题
光学相干断层扫描测量经皮下眼睑整形术后泪液的动态变化
DOI：
10.1016/j.ajo.2014.03.016
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发表时间：
2014-07-01
影响因子：
4.2
通讯作者：
Fan, Xianqun
中科院分区：
文献类型：
--
作者：
Shao, Chunyi;Fu, Yao;Fan, Xianqun
目的：探讨经皮下眼睑整形术后泪液的动态变化。设计：前瞻性、观察性病例系列研究。方法：30例经皮下眼睑整形术患者共60只眼参与本研究。所有受试者在术前以及术后1周、1个月和3个月时均完成了眼表疾病指数调查问卷，并接受了泪膜破裂时间测量和Schirmer测试。记录通过光学相干断层扫描测量的泪液半月板参数。还测量了下眼睑边缘反射距离。在手术后的每个时间点，将这些参数与基线参数进行比较。评估术后干眼和水肿的发生率。结果：术后1周眼表疾病指数评分显着增加（P < .01）。 Schirmer 测试值在术后 1 周显着下降 (P < .01)，并在 3 个月时恢复到基线。手术前后泪膜破裂时间无显着变化。泪液半月板高度、深度和横截面积值在术后 1 周显着增加，在 1 个月时下降 (P < .01)，并在 3 个月时恢复到基线 (P > .05)。角膜-下眼睑角在术后 1 周显着下降 (P < .01)，在 1 个月时增加 (P < .01)，并在 3 个月时恢复到基线 (P > .05)。术后1周下睑缘反射距离增加（P < .01），并逐渐恢复，但术后3个月尚未恢复至基线（P < .01）。泪液半月板高度增加与下睑缘反射距离呈正相关。术后1周干眼和水肿发生率分别为16.7%和15%。结论：美容经皮下睑成形术影响眼表和泪液，导致干眼、流泪和水肿。不过，这种影响在手术后是暂时的，症状会在3个月内消失。观察到泪液半月板高度与下睑缘反射距离呈正相关。利用光学相干断层扫描评估泪液半月板提供了一种快速、无创、定量的方法来研究眼睑成形术后泪液的动态变化。 （美国眼科杂志 2014 年；158:55-63。(C) 2014 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To investigate the dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty.DESIGN: Prospective, observational case series study.METHODS: A total of 60 eyes of 30 patients with transcutaneous lower blepharoplasty were involved in the study. All subjects completed the Ocular Surface Disease Index questionnaire and underwent tear film break-up time measurements and the Schirmer test before surgery and 1 week, 1 month, and 3 months after surgery. Tear meniscus parameters measured by optical coherence tomography were recorded. Lower lid margin reflex distance was also measured. At each time point after surgery, these parameters were compared with the baseline parameters. The incidence of dry eye and chemosis after surgery was assessed.RESULTS: The Ocular Surface Disease Index score increased significantly 1 week after surgery (P < .01). The Schirmer test values were significantly decreased 1 week postoperatively (P < .01), and they returned to baseline by 3 months. There was no significant change in tear film break-up time before and after surgery. The tear meniscus height, depth, and cross section area values were significantly increased at 1 week postoperatively, decreased at 1 month (P < .01), and returned to baseline at 3 months (P > .05). The cornea-lower eyelid angle significantly decreased at 1 week postoperatively (P < .01), increased at 1 month (P < .01), and returned to baseline by 3 months (P > .05). The lower lid margin reflex distance was increased 1 week after surgery (P < .01), and gradually recovered but had not returned to the baseline 3 months after surgery (P < .01). The increased tear meniscus height had a positive correlation with lower lid margin reflex distance. The incidence of dry eye and chemosis at 1 week postoperatively was 16.7% and 15%, respectively.CONCLUSIONS: Cosmetic transcutaneous lower blepharoplasty affects ocular surface and tear fluid, which leads to dryness, tearful eyes, and chemosis. However, this influence is temporary after surgery, and the symptoms resolve within 3 months. A positive correlation between tear meniscus height and lower lid margin reflex distance was observed. Assessment of the tear meniscus with optical coherence tomography provided a quick, noninvasive, and quantitative method to investigate the dynamic changes of the tear fluid after blepharoplasty. (Am J Ophthalmol 2014; 158:55-63. (C) 2014 by Elsevier Inc. All rights reserved.)