| Objectives:Meibomian gland dysfunction(MGD)can cause tear film abnormalities and ocular surface inflammatory reactions,leading to eye irritation symptoms.In severe cases,it may damage the cornea and affect visual function,and it is difficult to treat.At present,more and more attention has been paid to the influence of microorganisms on meibomian gland dysfunction.This study will study the morphology of meibomian gland and eyelid lipid microorganisms in patients with MGD,and explore the relationship between microorganisms and MGD.Methods:1.A total of 231 patients who met the MGD diagnostic criteria were selected from the ophthalmology clinic of Yunnan University Affiliated Hospital from2021.04 to 2022.04.According to the expert consensus on MGD severity grading,patients were divided into mild,moderate,and severe disease groups.Based on the questionnaire information,statistical analysis was conducted on the basic information of patients and specialized examinations.2.Collect and culture meibomian gland secretions from patients with MGD,and analyze the relationship between culture results and clinical grading of MGD.3.Based on the culture results of eyelid lipid microorganisms,the phospholipase and protease activities of Staphylococcus epidermidis with the highest positive rate of culture isolation were measured to explore the mechanism of action of Staphylococcus epidermidis on the occurrence and development of MGD.Results:1.Basic information: The gender proportion of the research object is more than that of women,accounting for 69%;The occupation is mainly non farmers,accounting for 76%;High educational level,mainly with a junior college or undergraduate degree(39%);The largest proportion of subjects who did not smoke and drank alcohol were 84% and 95%,respectively;The largest proportion of participants in outdoor activities was<3 hours,accounting for 57%;The sleep time of the study subjects is mostly concentrated in 7-8 hours,accounting for 65% of the population;Among the subjective symptoms of the study subjects,discomfort accounted for the largest proportion(97.4%).2.There were statistically significant differences in age,work,education,electronic product usage time,sleep time,and refractive error among MGD patients with different clinical grades;There were no significant differences in gender,smoking history,drinking history,outdoor activity time,systemic diseases,and systemic drug use.3.There was no statistical difference in the anterior examination results of MGD patients with different clinical grades.4.There was a positive correlation between OSDI score and corneal fluorescence staining and eye red;There was a negative correlation with the tear secretion test.BUT was positively correlated with corneal fluorescence staining and eye red;There is a negative correlation with the lacrimal river.There was a positive correlation between palpebral fat score and meibomian gland opening;The area of meibomian gland loss was positively correlated with BUT,redness,and lipid layer observation.5.There was no statistical difference in the positive rate of eyelid lipid microbial culture among MGD patients with different clinical grades.6.The microorganism with the highest positive rate of eyelid fat culture isolation in MGD patients with different clinical grades is Staphylococcus epidermidis.7.There are statistical differences in the phospholipase and neutral protease activities of Staphylococcus epidermidis cultured from eyelid lipids of MGD patients with different clinical grades.Conclusion:1.Age not only affects the occurrence of MGD,but also affects the development of MGD;Non farmer occupations and higher education levels may increase the opportunity and time for patients to use electronic products,while prolonged use of electronic products and reading can reduce blink rate and exacerbate the occurrence and development of MGD.2.The clinical grading of MGD cannot be based solely on the results of the previous analysis,but comprehensive consideration should be given to evaluating the overall condition of the ocular surface,eyelid,and meibomian gland.3.When meibomian gland abnormalities occur in patients with MGD,they affect the quality or quantity of eyelid fat,thereby affecting the ocular surface.The abnormality of the ocular surface in turn reacts on the meibomian gland,aggravating the development of MGD.4.Microorganisms may affect MGD through dysbacteriosis or microbial abundance.5.The differences in the activities of phospholipase and protease in Staphylococcus epidermidis isolated from eyelid lipids of MGD with different clinical grades may cause changes in eyelid lipids to varying degrees,which may have an impact on the occurrence and development of MGD. |
