| Objective:optical coherence tomography(OCT)was used to measure the tearmeniscus,TM)was compared with common dry eye examination techniques to find a highly sensitive,non-invasive and reproducible method for the diagnosis of dry eye,especially dry eye after cataract surgery,to guide clinical treatment.Methods:This study involved 33 patients(36 eyes)who underwent cataract Phacoemulsification of cataract combined with intraocular lens implantation in the Department of Ophthalmology,Huaihe Hosptal of Henan University from January 2022 to December 2022.Tear meniscus height(TMH)、tear meniscus area(TMA)、break-up time(BUT),Schirmer I test(SIt),fluorescein(FL)were measured and recorded on before and 1 week,2 weeks and 4 weeks after operation.pearson correlation analysis was used for correlation analysis,and Kappa coefficient was used for consistency analysis.receiver operating characteristic curve(ROC curve)was drawn and area underreceiver operating characteristic(ROC curve)was calculated curve,AUC)to determine the sensitivity and specificity of TMH and TMA in the diagnosis of dry eye,and determine the diagnostic threshold of TMH and TMA in the diagnosis of dry eye.Results:One week and two weeks after TMH surgery were statistically significant compared with the preoperative period(P<0.05),but no statistically significant difference was found at four weeks after surgery(P>0.05).TMH decreased significantly one week after surgery and slightly increased two weeks after surgery,and did not recover to the preoperative four weeks after surgery.One week and two weeks after TMA surgery were statistically significant compared with before surgery(P<0.05),and four weeks after surgery were not statistically significant compared with before surgery(P>0.05).TMA decreased significantly one week after surgery,but no significant change was observed two weeks after surgery,and did not recover to the preoperative level four weeks after surgery.The difference of Chinese dry eye score questionnaire one week after surgery,two weeks after surgery and four weeks after surgery was statistically significant(P<0.05).The score of China Dry eye score questionnaire was improved one week after surgery,but slightly decreased two weeks after surgery,and recovered to the preoperative level four weeks after surgery.BUT one week,two weeks and four weeks after surgery were statistically significant compared with those before surgery(P<0.05).One week after surgery BUT shortened,two weeks after surgery slightly extended,four weeks after surgery basically recovered to the preoperative.One week after SIt,two weeks after surgery and four weeks after surgery were statistically significant compared with those before surgery(P<0.05).SIt decreased significantly one week after surgery and increased slightly two weeks after surgery,but did not recover to the preoperative level four weeks after surgery.There were statistically significant differences in FL one week after surgery,two weeks after surgery and four weeks after surgery(P<0.05).FL increased significantly one week after surgery,decreased slightly two weeks after surgery,and almost recovered to preoperative four weeks after surgery.THM,THA showed the same trend as dry eye questionnaire,BUT,SIt and FL,and the comparison was statistically different.TMH was positively correlated with TMA before surgery,one week after surgery,two weeks after surgery and four weeks after surgery(P<0.001),TMH was positively correlated with BUT,SIt and FL one week after surgery,two weeks after surgery and four weeks after surgery(P<0.05),TMH was positively correlated with Chinese Dry eye score questionnaire four weeks after surgery.TMA was positively correlated with BUT,SIt and FL at one week,two weeks and four weeks after surgery(P<0.05),but had no significant correlation with Chinese dry eye score questionnaire at one week,two weeks and four weeks after surgery.There was no significant correlation between TMH,TMA and Chinese dry eye score at one week,two weeks and four weeks after surgery(P>0.05).There was no significant correlation among preoperative Chinese dry eye score,BUT,SIt and FL(P>0.05).Chinese dry eye score was positively correlated with SIt(P<0.05),BUT had no significant correlation with BUT and FL(P>0.05),but had significant positive correlation with SIt(P<0.01),but had no significant correlation with FL(P>0.05),and had no significant correlation with SIt(P>0.05).Two weeks after surgery,Chinese dry eye score was positively correlated with SIt(P<0.05),BUT had no significant correlation with FL(P>0.05),BUT had significant positive correlation with SIt(P<0.01),but had no significant correlation with FL(P>0.05),SIt had no significant correlation with FL(P>0.05).Four weeks after surgery,Chinese dry eye score was positively correlated with SIt(P<0.05),BUT not significantly correlated with FL(P>0.05),BUT significantly correlated with SIt(P<0.01),but not significantly correlated with FL(P>0.05),SIt was not significantly correlated with FL(P> 0.05),SIT was not significantly correlated with FL(P>0.05).TMH has strong consistency with BUT(Kappa=0.716,P<0.001),and poor consistency with dry eye questionnaire(Kappa=0.010,P=0.140),SIt(Kappa=0.075,P=0.019),FL(Kappa=0.048,P=0.400).TMA showed strong consistency with BUT(Kappa=0.622,P<0.001),but poor consistency with dry eye questionnaire(Kappa=0.032,P=0.140),SIt(Kappa=0.105,P=0.005),FL(Kappa=0.045,P=0.484).The dry eye questionnaire had a general strength agreement with SIt(Kappa=0.309,P<0.001),BUT had a poor strength agreement with BUT(Kappa=0.049,P=0.175)and FL(Kappa=0.160,P=0.140).BUT had poor consistency with SIt(Kappa=0.096,P=0.008)and FL(Kappa=0.051,P=0.419).There was general strength agreement between SIt and FL(Kappa=0.210,P=0.002).The sensitivity and specificity of TMH by Pearson analysis were 73.6% and 63.2%.The sensitivity and specificity of TMA were 66.7% and 70.6%.According to the above data,ROC curve was drawn and AUC was calculated: TMH was 0.745,TMA0.706.After the diagnostic sensitivity and specificity of the above measured values were cross-mapped and verified by the ROC curve,the relevant diagnostic boundary values were obtained as follows: TMH =244μm,TMA=0.022mm~2.Conclusion:Optically correlated tomography can directly and non-contact the morphology of lacrimal river clearly.It has the advantages of non-invasive,non-contact,convenient operation and high repeatability,and has good correlation and consistency with the measurement results of BUT,which has certain reference value for the diagnosis of dry eye,especially after cataract surgery. |
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