The Efficacy Of Punctal Occlusion And The Study Of Its Effects To Tear Film Lipid Layer

Objective:Using Lipiview ocular surface interferometer and traditional methods to evaluate the efficacy of punctal occlusion and verify the objective efficacy of Lipiview ocular surface interferometer,and to analyze the effects of punctal occlusion to tear film lipid layer,and to explore the correlation between LLT and other indicators.Methods:This study used a prospective,interventional approach.According to certain inclusion and exclusion criteria,14 patients(28eyes)with dry eye in the ophthalmological department of Union Medical College affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected,from may to July,2018.After the patients signing the informed consent,they were treated with Visi Plug punctal occlusion on the upper and lower lacrimal passages of both eyes.Ocular symptom score?BUT?FL and SIt were measured before operation?2 weeks after operation ?4 weeks after operation and 12 weeks after operation.And LLT?the number of blinking in 19.1 seconds ?the ratio of partial blinking and the volatility of LLT were also measured by using Lipiview ocular surface interferometer.Eyes were divided into group A(with lower lipid layer thickness),if LLT?60nm,and were divided into group B(with LLT> 60 nm lipid layer thickness),if LLT> 60 nm.The data were analyzed statistically by the paired-sample t test and Spearman rank correlation analysis.Results:1.During the observation period,ocular symptom score was reduced after operation,at baseline ?2 weeks after operation ?4 weeks after operation and 12 weeks after operation,mean ocular symptom score was 43.14±4.17?29.07±9.67?14.71±10.01?10.57±9.77,respectively(P<0.01);BUT was extended after operation,at baseline ?2 weeks after operation ?4 weeks after operation and 12 weeks after operation,mean BUT was 1.38±0.49s?2.88±1.22s?2.98±1.14s?3.43±1.16 s,respectively(P<0.01);FL was lower than it before operation,at baseline?2 weeks after operation ?4 weeks after operation and 12 weeks after operation,mean FL was 2.57±0.47?1.14±1.79?0.79±1.37?0.43±0.65,respectively(P<0.01);There was no statistical difference in the changes of SIt before and after operation.2.LLT bacame thicker after operation,at baseline ?2 weeks after operation ?4 weeks after operation and 12 weeks after operation,mean LLT was 68.96±18.35mm?80.04±19.99mm?78.68±16.07mm?77.82±17.47 mm,respectively(P<0.05).The number of blinking in 19.1 seconds was reduced after operation,at baseline?2 weeks after operation?4 weeks after operation and 12 weeks after operation,mean number of blinking was 8.00±4.14?6.38±3.69?5.71±2.91?7.08±3.57,the numbers of 2 weeks after operation and 4 weeks after operation had statistical significance(P<0.05),the number of 12 weeks after operation didn't have statistical significance(P>0.05);There was no significant difference in the volatility of LLT before and after operation,as well as PB.LLT of group A bacame thicker after operation,at baseline ?2 weeks after operation?4 weeks after operation and 12 weeks after operation,mean LLT was 50.11±7.41mm?72.22±14.67mm?76.00±16.34mm?64.22±8.61 mm,respectively(P<0.01),in addition,compared with all patients,LLT increased more significantly in group A patients after operation.3.At baseline,LLT had no correlation with ocular symptom score? BUT?FL and SIt(r=-0.195 P=0.504,r=0.091 P=0.757,r=0.197 P=0.499,r=-0.316P=0.271).There was also no correlation between any two of LLT?its volatility?blink rate and PB(P>0.05).Conclusion:Visi Plug has a obvious curative effect on dry eye.When evaluating the efficacy of punctal occlusion,Lipiview ocular surface interferometer is more objective,convenient and rapid,consistent with the results of the traditional methods.Punctal occlusion can not only increase the volume of water in the tear film,but also increase LLT,and it can be used for various types of dry eye.