Changes in ocular surface after withdrawal of anti-glaucoma medications following non-penetrating deep sclerectomy

Purpose: To analyze the ocular surface changes in eyes after the withdrawal of anti?glaucomatous drugs when non?penetrating deep sclerectomy (NPDS) is performed. Methods: Thirty?one patients (33 eyes) diagnosed with glaucoma that underwent NPDS were included in this prospective study. The control group included 33 eyes. Four variables were studied using Keratograph 5M (K5M): ocular hyperemia (OH), non?invasive tear film break?up time (NI?BUT), lower tear meniscus height (LTMH), and meibography. LTMH was also measured using the anterior segment module of a Spectralis Fourier?domain optical coherence tomography (FD?OCT) instrument. Moreover, an evaluation of corneal and conjunctival staining was performed. In the glaucoma group, five visits were carried out: pre?surgery, 1 week after surgery, and 1 month, 3 months, and 6 months after surgery. In control groups, examinations were performed in only one visit. In addition, patients were asked to answer two questionnaires: Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ?25) before and 6 months after surgery. Results: Before NPDS, eyes showed worse objective data than healthy control subjects (P ? 0.049). In this group, a significant improvement was observed in questionnaire responses (P < 0.001), LTMH?FD?OCT (P = 0.037), LTMH?K5M (P = 0.025), K5M?OH (P = 0.003), NI?BUT (P = 0.022), and conjunctival and corneal staining (P < 0.001). No significant differences were observed between groups in FD?OCT and K5M LTMH, NI?BUT, corneal?conjunctival staining, nor in the most OH sector values at 6 months (P ? 0.62). Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawal of the topical anti?glaucomatous treatment had a beneficial effect on the subjects

Clinical profile of dry eye disease at the Philippine General Hospital

Objectives@#To describe the population of dry eye disease (DED) patients seen at the Philippine General Hospital (PGH) Dry Eye Clinic, and to compare the diagnosis, type, and severity of DED using Oculus Keratograph® 5M (Oculus GmbH, Wetzlar, Germany) with clinical diagnosis.@*Methodology@#This was a single-center comparative, cross-sectional study. Newly-diagnosed DED patients were recruited for the dry eye group. A subset of healthy volunteers without DED was also recruited for the control group. The clinical data for both groups were collected, and the Ocular Surface Disease Index (OSDI) questionnaire was administered. Standard clinical dry eye testing and Keratograph testing were subsequently done. The PGH Dry Eye Clinic definitions were used to classify the types of dry eye. @*Results@#Eighty (80) eyes of 40 patients per group were examined. For the dry eye group, the mean age and OSDI scores were significantly higher, while the average tear break up time (TBUT) was significantly lower. There was no significant difference in average basal secretion test (BST) and Schirmer 1 measurements between the two groups. 73% had evaporative type dry eye, while 27% had mixed type. Majority of the DED patients were females of >50 years old with mild evaporative type. Foreign body sensation was the most common symptom. Overall, there was poor agreement between clinical and Keratograph assessments of diagnosis and severity among patients in the dry eye group, but there was acceptable agreement when assessment was done in the control group.@*Conclusions@#DED patients at the PGH have similar characteristics to reported DED of other Asian populations. Evaporative or short TBUT type dry eye is the most frequently seen. Further formal validity study is needed for Oculus Keratograph® 5M to increase the value of its data to be included in routine dry eye screening.

Experimental study on the diagnosis of dry eye tear film grading by Keratograph 5M ocular surface analyzer and conventional ocular surface examination / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the diagnostic value of Keratograph 5M for the diagnosis of dry eye(dry eye)tear film grading. <p>METHODS: Totally 100 eyes diagnosed with dry eye by conventional means and 40 non-dry eye eyes with suspected dry eye at the same time were enrolled through OPC. The immediate ocular surface parameters of the above cases were collected by the K5M ocular surface analyzer, including the first tear film rupture time(NIBUTf), the average tear film rupture time(NIBUTav), and the tear river height(TMH)which were utilized to evaluated the diagnostic efficacy of K5M compared to routine ocular surface examination on the index of dry eye tear film. <p>RESULTS: The comparison of NIBUTf, NIBUTav and TMH between dry eye group and non-dry eye group by K5M eye surface comprehensive analyzer showed statistically significant differences(all <i>P</i><0.05). The coincidence rate between the NIBUTf of K5M ocular surface analyzer and the BUT of routine diagnosis was 78.6%, and the area under the ROC curve as well as the standard error were 0.042 and 0.795(<i>P</i><0.01)with 95% confidence interval(0.712, 0.878); The coincidence rate between NIBUTav of K5M and BUT of routine examination diagnosis was 73.6%, and the area under the ROC curve as well as the standard error were 0.853 and 0.033(<i>P</i><0.01), with 95% confidence interval(0.788, 0.917).The coincidence rate between TMH of K5M and the SⅠt of conventional diagnosis was 87.9%, and the area under the ROC curve as well as the standard error were 0.795 and 0.044(<i>P</i><0.01), with the 95% confidence interval(0.709, 0.880). The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTf combined with TMH were 98, 40, 38, 1.63, 0.05, and 32.6%, respectively. The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTav combined with TMH were 86, 75, 61, 3.44, 0.187, 18.39%, respectively.<p>CONCLUSION: K5M ocular surface analyzer can provide accurate and reliable diagnostic value for single tear film index grading diagnosis of dry eye; compared with TMH combined with NIBUTav, TMH combined with NIBUTf was more sensitive but less specific in diagnosing dry eye.

Ocular surface analysis in gestational diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate ocular surface functions in pregnant women with gestational diabetes mellitus(GDM)using Keratogragh 5M. <p>METHODS: Pregnant women with GDM and normal pregnant women were enrolled. All subjects were asked to answer ocular surface disease index(OSDI)questionnaire survey, and then underwent ophthalmic examination including tear meniscus height(TMH), average noninvasive Keratograph tear film break-up time(NIKBUTav), ocular redness analysis, and meibomial gland analysis.<p>RESULTS: There were no statistically significant differences in OSDI, TMH, NIKBUTav, eye redness analysis and meibomial gland analysis between the GDM group and the normal pregnant group(<i>P</i>>0.05). The OSDI scores were 8.02±4.25 and 7.50±4.28(<i>P</i>=0.557), TMH values were 0.22±0.05 and 0.20±0.04mm(<i>P</i>=0.158), NIKBUTav values were 8.01±2.15s and 8.02±1.53s(<i>P</i>=0.971).<p>CONCLUSION: There was no statistically significant difference between the GDM group and the normal pregnant group in ocular surface indexes. GDM had no negative effects on ocular surface, which may be related to good controlling of the blood glucose.

Influence of pars plana vitrectomy on ocular surface using noninvasive Keratograph 5M / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the influence of pars plana vitrectomy(PPV)on ocular surface using Keratograph 5M. <p>METHODS: Totally 30 consecutive patients(30 eyes)undergoing primary 23G PPV were recruited in the study. Ocular Surface Disease Index(OSDI)questionnaire was performed. Ocular surface parameters, including tear meniscus height(TMH), noninvasive tear break up time(NITBUT)and bulbar redness score were obtained preoperatively, in 2, 4, 8 and 12wk postoperatively by Keratograph 5M. Correlations between all the clinical parameters were analyzed further.<p>RESULTS: The percentages of both photophobia and gritty within 4wk after PPV were significantly higher than preoperation, while they decreased to the preoperative levels in both 8wk and 12wk postoperatively. The percentage of sore eyes in the first week postoperatively was significantly higher than preoperation, but there were no significant differences between the percentages of preoperation and 2, 4, 8 and 12wk postoperatively. OSDI score increased significantly within 4wk postoperatively, but it returned to the preoperative level in 8 and 12wk. TMH increased with 2wk postoperatively, but there were no significant differences compared with preoperation. Both NITBUT-first and NITBUT-average shortened significantly within 8wk postoperatively, but they gradually improved to the preoperative levels in 12wk. Bulbar redness score was significantly higher than the preoperative level within 4wk postoperatively, but it returned to the preoperative level in 8wk. NITBUT-first and NITBUT-average had a significant positive correlation at each visit. TMH had a significant positive correlation with NITBUT-average in the first week postoperatively.<p>CONCLUSION: Keratograph 5M can provide a reliable noninvasive method to assess the influence of PPV on the ocular surface. PPV may cause various changes in both symptoms and signs of ocular surface damages at the early stage, while all these changes will return to preoperative levels gradually in 12wk postoperatively.

Effect of trabeculectomy and phacoemulsification combined with trabeculectomy on the ocular surface / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the effects of trabeculectomy and phacotrabeculectomy on the ocular surface using ocular Keratograph 5M.<p>METHODS: Totally 62 eyes of 62 patients with coexisting primary angle-closure glaucoma(PACG)and cataract were recruited. Thirty-two eyes accepted trabeculectomy, and the remaining thirty eyes accepted phacotrabeculectomy. Ocular surface parameters, including noninvasive first tear film break-up time(NifTBUT), noninvasive average tear film break-up time(NiaTBUT), corneal fluorescein staining scores(CFS)and tear meniscus height(TMH), were analyzed preoperatively, 3d, 1mo and 3mo postoperatively, with ocular Keratograph 5M.<p>RESULTS: There was no significant difference in ocular surface parameters between the two groups preoperatively(<i>P</i>>0.05). The values of NifTBUT, NiaTBUT, CFS and TMH in phacotrabeculectomy eyes were at the worse levels, <i>i.e.</i> 10.13±1.48s, 12.59±1.96s, 0.80±0.22 and 0.31±0.02mm, respectively at 3d postoperatively, then improved gradually at 1mo postoperatively, but did not return to the preoperative levels at 3mo postoperatively.<p>CONCLUSION: Ocular Keratograph 5M can be used to evaluate the changes of tear film in combined anti-glaucoma surgery accurately. The effects of phacotrabeculectomy on ocular surface are worse than that of trabeculectomy during 3mo after surgery. It is suggested that more eye care should be paid during that period of time.

Changes of dry eye parameters after femtosecond laser and conventional LASIK / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the changes of dry eye symptoms and signs after femtosecond-assisted laser <i>in situ</i> keratomileusis(LASIK)and conventional LASIK by Keratograph 5M.<p>METHODS: Sixty patients(120 eyes)who underwent corneal refractive surgery from June 2017 to November 2017 were enrolled. Thirty patients(60 eyes)underwent femtosecond-assisted laser LASIK and 30 patients(60 eyes)underwent conventional LASIK. All patients took examinations of Keratograph 5M dry eye related examinations,routine ophthalmological examinations and ocular surface disease index(OSDI)questionnaire before and 1wk, 1mo, 3mo and 6mo after surgery.<p>RESULTS: One week after operation, the OSDI scores of two groups were significantly higher than pre-operation(<i>P</i><0.01), but 1mo after operation, the two groups recovered to the preoperative level(<i>P</i>>0.05). Noninvasive tear film break-up time(NI-BUT)in the conventional group was shorter 1wk, 1mo and 3mo after operation(<i>P</i><0.01), while it was shorter in 1wk and 1mo after operation in femtosecond laser group(<i>P</i><0.01). There was significant difference between conventional group and femtosecond laser group at 3mo after operation in NI-BUT(<i>P</i><0.01). Tear meniscus hight(TMH)and the thickness of lipid layers of the two groups all decreased in 1wk and 1mo after operation(<i>P</i><0.05).<p>CONCLUSION: Whether femtosecond-assisted or conventional LASIK will affect tear film stability and cause dry eye symptoms. The degree of influence decreases gradually with the time after operation, but femtosecond laser group can recover more quickly.

Ocular surface change of primary pterygium with OCULUS keratograph / 中华实验眼科杂志

Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph.Methods A prospective case observation study was performed.Thirty-nine (55 eyes) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital.The area of the pterygium invaded cornea and duration of pterygium were recorded.The ocular surface condition was detected by corneal fluorescein staining.The break up time of tear film (BUT) and the gland function score were measured with OCULUS Keratograph.This study was approved by the Ethics Committee of Zhongshan People's Hospital (2015 [13]).All operations followed the Helsinki Declaration and all patients signed informed consent forms.Results The areas of pterygium invaded cornea was 2-20 mm2,the mean size was 5 (3,10) mm2;the duration of pterygium was 3-8 years,the mean duration was 5 (4,6)years;the BUT was 2.1-15.0 seconds,the mean BUT was (6.3±3.0) seconds.The mean gland function score was 2 (1,3).The area of pterygium was not significantly correlated with the duration of pteryguim (r =0.197,P =0.148),while it was negatively correlated with BUT (r=-0.711,P＜0.001) and positively correlated with the tarsal gland score (r =0.554,P＜0.001).What's more,82％ (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head.Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non-contact and non-invasive method.Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients.

Study on the difference of clinical manifestations of dry eye between children and adults / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the difference of dry eyes between children and adults in terms of symptoms and laboratory examinations.<p>METHODS: Patients in 2018-06/2019-02 with the subjective symptoms of dry eye, and served in Xi'an First Hospital, including 52 children clinic cases(52 eyes)and 55 adult patients cases(55 eyes), all the cases were consulted and examined by slit lamp microscope in anterior segment. Both eyes of tear meniscus height(TMH), the first tear film break-up time(BUTf), the average tear film break-up time(BUTave), lipid layer thickness(LLT)and mesangial gland loss rate were measured by a Keratograph 5M non-invasive ocular surface analyzer.<p>RESULTS: In children, patients' TMH(0.15±0.04mm), BUTf(3.22±1.24s), BUTave(4.27±1.67s), and the rate of meibomian gland loss \〖0.00%(0.00%, 5.03%)\〗 were significantly lower than those in the adult group [0.20±0.05mm, 4.36±1.93s, 5.15±1.49s, 9.90%(5.30%, 18.40%), all <i>P</i><0.01]. The LLT in the children was higher than that of the adult group, and the difference was not statistically significant(72.31±22.20nm <i>vs</i> 68.58±21.05nm, <i>P</i>>0.05). Both groups of patients had positive correlation sympathise with BUTf and BUTave, with no correlation between LLT and meibomian gland loss rate in children(<i>r</i>s=-0.23,<i>P</i>=0.10), and adult group patients with negative correlation of LLT and meibomian gland loss rate(<i>r</i>s=-0.28,<i>P</i><0.05).<p>CONCLUSION: Children's dry eyes and adult dry eyes in the symptoms, clinical manifestations and examination are different. The main symptom is the increase in the number of blinks. The inspection is mainly characterized by a short BUT. With the decrease of TMH, the rate of meibomian gland loss is relatively insignificant.

Changes of ocular surface before and after phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate ocular parameters changes after age-related cataract phacoemulsification surgery using Keratograph 5M combined with conjunctival impression cytology.<p>METHODS: This prospective study included 39 eyes(39 patients)from December 2016 to December 2017, who underwent cataract phacoemulsification and intraocular lens implantation in Fujian Provincial Hospital. OSDI questionnaire, tear meniscus height, tear break-up time, conjunctival hyperemia and impression cytology were performed preoperatively at 1d, 1wk, 1mo and 2mo after surgery.<p>RESULTS: GCD and OSDI were worsen at 1d, 1wk, 1mo, 2mo, postoperatively(<i>P</i><0.05). The first-time tear break-up time was significantly shorter at 1wk(6.91±4.52, 6.12±3.55, 5.18±3.37, 6.28±4.70, 5.96±3.17s, <i>P</i><0.05). The average tear break-up time was significantly shorter at 1wk(10.21±5.20, 8.89±4.47, 6.87±3.68, 7.35±3.52, 9.00±4.23s, <i>P</i><0.05).<p>CONCLUSION: phacoemulsification will influence ocular surface parameters. The tear instability and conjunctival cell damage began at 1d postoperatively, and aggravated at 1wk postoperatively. It still couldn't return to preoperative level even at 2mo postoperatively.

Correlation between dry eye and refractive error in Saudi young adults using noninvasive Keratograph 4

Purpose: The purpose is to study the correlation between dry eye and refractive errors in young adults using noninvasive Keratograph. Methods: In this cross sectional study, a total of 126 participants in the age range of 19� years and who were free of ocular surface disease, were recruited from King Saud University Campus. Refraction was defined by the spherical equivalent (SE) as the following: 49 emmetropic eyes (�50 SE), 48 myopic eyes (??0.75 SE and above), and 31 hyperopic eyes (>+0.75 SE). All participants underwent full ophthalmic examinations assessing their refractive status and dryness level including noninvasive breakup time (NIBUT) and tear meniscus height using Keratograph 4. Results: The prevalence of dry eye was 24.6%, 36.5%, and 17.4% in emmetropes, myopes, and hypermetropes, respectively. NIBUT has a negative correlation with hyperopia and a positive correlation with myopia with a significant reduction in the average NIBUT in myopes and hypermetropes in comparison to emmetropes. Conclusion: The current results succeeded to demonstrate a correlation between refractive errors and dryness level.

Ocular surface change of primary pterygium with OCULUS keratograph / 中华实验眼科杂志

Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph. Methods A prospective case observation study was performed. Thirty.nine ( 55 eyes ) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital. The area of the pterygium invaded cornea and duration of pterygium were recorded. The ocular surface condition was detected by corneal fluorescein staining. The break up time of tear film ( BUT) and the gland function score were measured with OCULUS Keratograph. This study was approved by the Ethics Committee of Zhongshan People's Hospital ( 2015 [ 13 ] ) . All operations followed the Helsinki Declaration and all patients signed informed consent forms. Results The areas of pterygium invaded cornea was 2-20 mm2,the mean size was 5(3, 10)mm2;the duration of pterygium was 3-8 years,the mean duration was 5(4,6)years;the BUT was 2. 1-15. 0 seconds,the mean BUT was (6. 3±3. 0) seconds. The mean gland function score was 2(1,3). The area of pterygium was not significantly correlated with the duration of pteryguim (r=0.197,P=0.148),while it was negatively correlated with BUT (r=-0. 711, P<0. 001 ) and positively correlated with the tarsal gland score (r=0. 554,P<0. 001). What's more,82％ (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head. Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non. contact and non.invasive method. Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients.

Effect of forced eye opening on non -invasive tear film break - up time by Keratograph 5M in healthy individuals / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the difference of non - invasive tearfilm break - up time (NIBUT) by Keratograph 5M beforeand after forced eye opening in healthy individuals.METHODS: Prospective case self - control study. Fortynormal volunteers (79 eyes ) were enrolled. Tear filmimages were captured, non-invasive first tear film breakuptime(NIBUTf ), non- invasive average tear film breakuptime (NIBUTav ) and dry eye level were measured byKeratograph 5M automatically before and after forced eyeopening in each subject. For the first time, we checkedthe left eye after the right eye, and the second timechecked the right eye after the left eye.RESULTS: The average of NIBUTf and NIBUTav were9 18士5. 52s, 11. 74 士5. 59s respectively and percentage ofevery level of dry eye were 43% , 37% , 20% respectivelybefore forced eye opening. The average of NIBUTf andNIBUTav were 8. 91士5. 54s, 11. 76士5. 58s and percentage ofdry eye at different levels were 35% , 48% , 16%respectively after forced eye opening. There was nosignificant difference on NIBUT and dry eye level byOculus keratograph 5M in normal subjects (t = 0. 37, P =0 72; t = -0. 038, P = 0. 97; Z = -0. 42, P = 0. 68).CONCLUSION: There is no influence on NIBUT and dryeye level by detected Keratograph 5M before and afterforced eye opening in healthy subjects.

A Pilot Study of Changes in Tear Film Short-term Dynamics with Infrared Imaging after Phacoemulsification

PURPOSE: To evaluate the short-term changes in tear film dynamics with non-invasive infrared imaging measurement before and after cataract surgery as a pilot study. METHODS: Seventeen eyes of 17 patients without preoperative dry eye were enrolled in this study. Non-invasive keratograph tear break-up time (NIK-TBUT) and non-invasive keratograph tear meniscus height (NIK-TMH) were measured before and 1 day, 1 week, and 1 month after cataract surgery using a keratograph. RESULTS: The mean patient age was 64.47 ± 10.28 years, and 78.95% were female. Although the mean postoperative 1 day NIK-TBUT-first value was not significantly different from the preoperative value, the mean postoperative 1 week and 1 month NIK-TBUT-first values were significantly lower than preoperative values (p < 0.05). The postoperative 1 day, 1 week, and 1 month NIK-TBUT-average and the NIK-TMH values were not different from preoperative values. CONCLUSIONS: Our study showed that cataract surgery can lead to tear film instability. And it is important to determine the long-term outcomes of surgery and whether NIK-TBUT and NIK-TMH correlate with slit lamp examination tear break-up time (SLE-TBUT) and slit lamp examination tear meniscus height (SLE-TMH).

Effectiveness and comfort of Oculus Keratograph on tear film function test before corneal refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore correlation,consistency and comfort between traditional tear film examination methods and Oculus Keratograph.METHODS: A retrospective study.Totally 101 cases (101 eyes) were diagnosed myopia and then accepted LASEK (laser epithelial keratomileusis).Non-invasive tear film break-up time(NIBUT),lower tear meniscus height(LTMH) were measured with Oculus Keratograph,fluorescein tear film break-up time(fl-BUT) and Schimer Ⅰ test (SⅠt) were performed on all cases.The correlations analysis between NIBUT and fl-BUT,LTMH and SⅠt were performed by Spearman rank correlation,consistency check between NIBUT and fl-BUT by Bland-Altman analysis.Visual analogue scale(VAS) was applied on evaluating the comfort of two kinds of examination methods.RESULTS: LTMH and SⅠt showed positive correlation (rs=0.346,P=0.001).NIBUT and fl-BUT showed positive correlation (rs=0.393,P=0.001),95% consistency limits range-9.62 to 14.18 in Bland-Altman Figure.There was significant difference between VAS of NIBUT and VAS of fl-BUT(z=-2.324,P=0.020).There was significant difference between VAS of LTMH and VAS of SⅠt (z=-8.845,P=0.001).CONCLUSION: Oculus Keratograph can objectively measure NIBUT and LTMH,and was more comfortable than traditional tear film examination methods.It can effectively assess tear film function before corneal refractive surgery.

Morphological evalution of obstructive meibomian gland dysfunction by noninvasive Keratograph / 中华实验眼科杂志

Background Obstructive meibomian gland dysfunction (OMGD) is due to the meibomian gland duct obstruction and/or meibum abnormal secretion.Meibomian gland morphological change is important to clinical observation.Objective This study aimed to image the meibomian gland structures and the morphological changes in eyes with OMGD using a non-contact infrared meibography system (Keratograph 5M).Methods A case-control study was performed in Tianjin Medical University Eye Hospital from January to June in 2015.Sixty OMGD patients and 60 age-matched healthy controls were recruited.Ocular Surface Disease Index (OSDI) questionnaire was employed for the assess of ocular surface symptoms,and slit-lamp examination was performed for the observation of lid margin and meibomian gland orifices.Meibomian gland secretion scores and Keratograph 5M examination the morphological changes of the meibomian glands.According to OSDI questionnaire,the patients of OMGD were classified into mild group (12.0 ＜ OSDI ≤ 22.0) (23 eyes),moderate group (22.0 ＜ OSDI ≤ 32.0) (21 eyes) and severe group (32.0 ＜ OSDI ≤ 100.0) (16 eyes).Partial or complete loss of the meibomian glands (meibomian dropout) was scored from grade 0 (no loss) through out grade 3 (lost area was ＞2/3 of the total meibomian gland area).Written informed consent was obtained from all subjects before the examination.Results The OSDI,meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores were significantly higher,and BUT was dramatically shorter in the OMGD group than those in the normal group,showing significant differences between the two groups (Z =-9.425,-8.954,-7.781,all at P＜0.05).The BUT was (6.10± 1.91) s and (10.67-±2.11)s,and meibomian gland dropout scores were 1.35±0.90 and 0.88±0.64 in the OMGD group and normal control group,showing significant differences between the two groups (t=3.276,-12.418,both at P＜0.05).OSDI,meibomian gland secretion scores and meibomian gland dropout scores were significantly in three intergroups (H=52.121,13.642,37.180,all at P＜0.05).BUT,meibomian gland orifices were significantly different among the mild,moderate and severe OMGD (F=58.191,8.474,both at P＜0.05).OSDI showed a significantly high positive correlation with meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores (r =0.708,P =0.000;r =0.759,P =0.000;r =0.270,P =0.003).BUT showed negative correlation with meibomian parameters (r=-0.692,P=0.000;r=-0.691,P=0.000;r=-0.192,P=0.036).Conclusions Keratograph 5M provides an effective noninvasive method in assessing the image of the meibomian gland structures and meibomian gland dropout.There are differences in the ocular surface and meibomian glands between the OMGD patients and normal persons.

Evaluation of Meibomian gland in different age groups with dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the condition of Meibomian gland in different age groups patients with dry eye. <p>METHODS: There were divided into A to H groups according to age that 301 patients(598 eyes)with dry eye in our hospital of November 2015 to April 2016, a total of eight groups. We evaluated the condition of Meibomian gland of them through the OCULUS Keratograph, including the loss of the Meibomian gland, the shape of the Meibomian gland, eyelid ester and obstructed or not of the Meibomian gland orifices, etc. <p>RESULTS: There had lost of the Meibomian gland of all patients with dry eye in this study, the differences between the eight groups were statistically significant(<i>χ</i>²=336, <i>P</i><0.05).The number of Meibomian gland of group A had no loss. The differences between the B～H groups were statistically significant(<i>F</i>=36.4357,<i>P</i><0.05). Glands shape had become thin when the age was more than forty, getting worse as the growth of the age gradually. The differences eyelid ester and obstructed or not of the Meibomian gland orifices between the A～H groups were not statistically significant. <p>CONCLUSION: The OCULUS Keratograph can provide the objective and precise condition of Meibomian gland in each group of patients with dry eye for us, and the change rule of quantitative results. it can provide the diagnosing judgment for the patients of dry eye, and provide methods for clinical treatment.

Reliability of a New Non-invasive Tear Film Break-up Time Measurement Using a Keratograph

PURPOSE: To evaluate the repeatability of non-invasive tear film break-up time and identify its relationships with dry eye parameters. METHODS: A total of 100 participants (50 with dry eye, and 50 in the control group) were enrolled prospectively. Non-invasive keratograph first (NIKf-BUT) and average (NIKav-BUT) break-up times were evaluated 2 times using Keratograph 4 (Oculus, Wetzler, Germany), and then tear film break-up time with fluorescein (FBUT) was measured. The correlation analyses were performed between non-invasive parameters (NIKf-BUT and NIKav-BUT) and FBUT. Intra-observer agreements of NIKf-BUT and NIKav-BUT were assessed using intraclass correlation coefficients (ICC). The receiver operating characteristic (ROC) curve technique was used to evaluate the non-invasive method in the diagnosis of dry eye. RESULTS: The correlation analyses revealed positive correlation between NIKav-BUT and FBUT in both groups (dry eye; r = 0.66, p < 0.001 and control group; r = 0.77, p < 0.001). The ICCs of NIKf-BUT and NIKav-BUT were 0.72 and 0.94 in the dry eye, respectively, and 0.70 and 0.91 in the control group. NIKav-BUT was not different from FBUT in either group. The areas under the ROC curves of NIKf-BUT and NIKav-BUT were 0.917 and 0.980, respectively. CONCLUSIONS: The high ICCs verified the repeatability of NIKf-BUT and NIKav-BUT. NIKav-BUT showed no difference from FBUT and positive correlation with FBUT. NIK-BUT showed high diagnostic power and can be considered a new parameter to evaluate dry eye syndrome.

Measurement of Corneal Power and Astigmatism Using Placido-based Videokeratography and Comparison with Other Keratometers

PURPOSE: In the present study, the repeatability and reproducibility of the corneal power and astigmatism measurements using placido-based video keratography were evaluated and the agreement with other keratometers were compared. METHODS: This prospective study included 45 patients (45 eyes) scheduled to undergo cataract surgery between November 2015 and January 2016. Three sets of corneal power and astigmatism were measured using placido-based video keratometer (Keratograph® 5M), automatic keratometer (KR-8900®), manual keratometer (B×L manual keratometer®), Placido-scanning-slit keratometer (ORBscan II®), Scheimpflug keratometer (Pentacam®), and low coherence interferometry (Lenstar LS900®). Reliability of each device was analyzed using the coefficient of variation, standard deviation and intraclass correlation coefficient. Repeated measures analysis of variance was used to analyze the interdevice comparison of mean absolute difference. The agreement between the devices was evaluated with 95% limits of agreement (LoA) and Bland-Altman plots. RESULTS: The mean corneal power, astigmatism and power vector analysis (J₀, J₄₅) were not significantly different among devices (p > 0.05). In the Bland-Altman plot analysis, the 95% LoA of corneal power, J₀, and J45 when comparing Keratograph® 5M with others ranged from -0.78 to 0.55 D, from -0.42 to 0.45 D, and from -0.39 to 0.47 D, respectively. CONCLUSIONS: Keratograph® 5M showed good repeatability and reproducibility of corneal power and astigmatism measurements and was interchangeable with other keratometers.

Observation of the early tear film changes after trabeculectomy with Keratograph 5 M / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To observe the early tear film changes after trabeculectomy using Keratograph 5M.METHODS:Fourty-one patients (46 eyes) of glaucoma who underwent trabeculectomy were involved. First tear break up time ( FTBUT ) , average tear break up time (ATBUT), non-invasive tear meniscus height (NlTMH), lipid layer thickness and meibomian gland scores were measured at 1d preoperatively and at 1d, 1wk, 1mo postoperatively.RESULTS:At 1d, 1wk and 1mo postoperatively, FTBUT and ATBUT decreased greatly (P0. 05). CONCLUSlON: Keratograph 5M could be used to evaluate tear film function rapidly and accurately. Trabeculectomy significantly alters tear film stability and tear secretion in the short term after operation.