Assessment of Tear Lipid Layer after Treatment by an Infrared Instrument

PURPOSE: We performed this study to evaluate the influence on tear film of infrared instrument by observing the morphologic change of the tear lipid layer and tear break-up time by Tearscope(R). METHODS: The subjects were 52 eyes from 26 people. After infrared hyperthermic therapy, we analyzed the change of the tear lipid layer by Tearscope(R) at 10 minutes, 6 hours, and 12 hours. We also observed the subjective symptoms of change related to dry eye syndrome and tear break-up time. RESULTS: Of the 26 normal cases, 20 were men and 6 were women. The mean age was 26.4 +/- 1.9 years. The subjective symptoms improved and the tear lipid layer showed a decrease of color fringe yellow-brown and color fringe multiple colors type, and an increase of waves and closed meshwork type 10 minutes and 6 hours following infrared treatment. Tear break-up time was also prolonged from preoperative value of 10.0 +/- 2.4 seconds to 11.0 +/- 2.7 and 11.1 +/- 2.9 seconds at 10 minutes and 6 hours, respectively, after infrared treatment, but this effect did not persist after 12 hours. Schirmer test value did not show significant change. No complication related to infrared treatment was noted. CONCLUSIONS: Infrared treatment may be considered a possible method of treating dry eye syndrome by increasing the stability of the tear lipid layer.

Characteristics of Tear Lipid Layer Patterns on Tearscopy and Lipid Layer Thickness

This study is to evaluate thickness of lipid layer, NIBUT (non-invasive tear film break-up time), BUT and Schirmer value according to tearscopic pattern of lipid layer.The subjects are seventy-one eyes from seventy-one people without ocular diseases.The pattern of lipid layer is observed by Tearscope(r) (Keeler, U.K.)and the thickness of lipid layer is measured by interference generated from slit lamp microscope.The thickness of lipid layer, NIBUT and BUT are respectively measured three times and averaged.In the case of the pattern of lipid layer, eighteen eyes have the close meshwork type, twenty-nine eyes have the wave type, fifteen eyes have the amorphous type and nine eyes have the color fringe type.The average value of the thickness of lipid layer, NIBUT, BUT and Schirmer test were respectively 29.3 nm, 25.9 seconds, 12.0 seconds, 18.6 mm for close meshwork;47.2 nm, 33.6 seconds, 12.5 seconds, 16.9 mm for wave;66.2 nm, 39.7 seconds, 14.9 seconds, 18.7 mm for amorphous;and 74.4 nm, 30.9 seconds, 13.9 seconds, 18.9 mm for color fringe.The thickness of lipid layer was different significantly among the patterns.NIBUT showed significant difference between close meshwork and wave, and between close meshwork and amorphous.The Cronbach alpha, reproducibility of the test, is 0.84 in the thickness of lipid layer, 0.64 in NIBUT, 0.76 in BUT and 0.94 in Schirmer test.The reproducibility of the pattern of lipid layer observed by Tearscope(r) is 95.8%.