| Objective: The aim of our study was to comparing the differences in ocular surface conditions such as the tear film,meibomian glands,and corneal endothelium among people with type 2 diabetes and non-diabetic people,observe the influence of the diabetes on the ocular surface,and to explore the correlation between changes in ocular surface and the duration of diabetes and glycated hemoglobin levels.Methods:The study enrolled 68 patients with type 2 DM receive treatment in the Second Affiliated Hospital of Chongqing Medical University From April to June 2019 as the diabetes group who diagnosed as cataract,and 98 non-diabetic patients treated for cataracts in the ophthalmology clinic during the same period as the control group.Recorded the course of diabetes,and tested for HbA1c.All subjects were examined in three aspects: dry eye,meibomian gland and corneal endothelium.Dry eye related examinations include: SPEED score(standard patient evaluation of dryness,SPEED questionnaire for short),break-up time(BUT),tear secretion test(Schirmer I test,SIt),corneal fluorescein staining score.The parameters of meibomian gland include the score of meibomian margin and meibomian gland opening,meibum expression assessment score,lipid layer thickness(LLT)of the tear film,and the rate of meibomian gland loss,and corneal endothelial related indicators included:corneal endothelial cell coefficient of variation(CV),corneal endothelial cell density(CD),hexagonal cell ratio(6A),average area of corneal endothelial cells.Comparing the the differences in ocular surface indicators between the two groups and analyzing the relationship between changes in ocular surface indicators of patients with diabetes and the course of diabetes HbA1c.Results: Difference analysis: The BUT and SIt in the diabetic group were significantly lower than those in the control group,and the corneal fluorescence staining score was higher than that in the control group(p <0.05).There was no significant difference in SPEED score between the two groups(P > 0.05).Among the meibomian gland-related indicators,the score of meibomian margin and meibomian gland opening and the rate of meibomian gland loss were significantly higher in the diabetic group than in the control group(P <0.05),while meibum expression assessment score and tear film LLT were significantly lower than these in the control group(P <0.05).Among corneal endothelium-related indicators,CV in the diabetic group were significantly higher than those in the control group,while CD and 6A were significantly lower than those in the control group(P <0.05),there was no significant difference in mean area of endothelial cell.Correlation analysis in the diabetes group: there was a negative correlation between the duration of diabetes and the meibomian gland excretion score,tear film LLT,CD,6A(P <0.05),and positive correlation with the meibomian gland loss rate,CV,and the average area of endothelial cells(P <0.05),and there was no statistically significant correlation between the duration of diabetes and the SPEED score,BUT,SIt,corneal fluorescence staining score,eyelid margin,meibomian gland opening score and mean area of endothelial cell(P> 0.05).HbA1c was negatively correlated with BUT,SIt,CD,and 6A(P <0.05),and positively correlated with meibomian margin and meibomian gland opening score,CV,and average cell area(P <0.05),and there was no correlation between the fluorescent staining score,meibomian gland drainage ability score,tear film LLT meibomian gland loss rate and mean area of endothelial cell(P> 0.05).Conclusion: Compared with non-diabetic patients,the ocular surface of patients with type 2 diabetes has the characteristics of less obvious dry eye symptoms,lower tear film stability,less tear secretion,more severe meibomian gland damage,and greater changes in corneal endothelial morphology.The degree of damage increases with the duration of diabetes.And changes of ocular surface in patients with diabetes has a certain correlation with the duration of diabetes and the level of HbA1c. |
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