Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Protez Göz Kullanan Hastalarda Meibomian Bez Disfonksiyonunun Değerlendirilmesi: Vaka-Kontrol Araştırması
Evaluation of Meibomian Gland Dysfunction in Patients Wearing Prosthetic Eyes: Case-Control Study
Rüveyde BOLAÇa, Gizem YELb, Ece TURAN VURALa
aSağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Göz Kliniği, İstanbul, Türkiye
bGazipaşa Devlet Hastanesi, Göz Hastalıkları Kliniği, Antalya, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(3):172-7
doi: 10.5336/ophthal.2022-89470
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, protez göz kullanan hastalarda meibomian bez disfonksiyonunun oküler rahatsızlık nedeni olup olmadığını araştırmayı ve protez gözlerin meibomian bez üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışmaya protez göz kullanan 24 hasta dâhil edildi. Her iki göz meibomian bez morfolojisi meibografi (Cirius, CSO, İtalya) ile değerlendirildi. Meibomian bezlerin kaybı Evre 0 (kayıp yok), Evre 1 (<%25), Evre 2 (%25-50), Evre 3 (%50-75) ve Evre 4 (>%75) olarak değerlendirildi. İnferior gözyaşı menisküs parametreleri optik koherens tomografi (Optovue, Inc., Fremont, ABD) ile ölçüldü. Kapak kenarı anormallikleri yarıklı lamba biyomikroskop ile muayene edildi. Hastalardan oküler semptomları değerlendiren anketi doldurmaları istendi. Bulgular: Hastaların %50'si kadındı ve yaş ortalaması 52,5±16,8 (18-87) yıldı. Protez gözün göz kapaklarında üst kapak meiboskor 2,4±0,50 (2-3), sağlıklı gözün göz kapaklarında üst kapak meiboskor 1,50±0,58 (1-3) olup protez gözde anlamlı yüksekti (p<0,001). Alt kapak meiboskor ve gözyaşı menisküs yüksekliği açısından 2 grup arasında anlamlı fark saptanmadı (sırasıyla p=0,07, p=0,90). Gözyaşı menisküs derinliği ve gözyaşı menisküs alanı protez gözlerde sağlıklı gözlere göre anlamlı yüksek saptandı (sırasıyla p=0,009, p=0,02). On yıldan uzun süre protez göz kullananlarda ise oküler semptom skoru daha yüksek saptandı (p<0,001). Sonuç: Protez göz kullanan hastalarda sağlıklı göz ile karşılaştırıldığında üst göz kapaklarında önemli meibomian bez kaybı olmaktadır. Meibomian bez disfonksiyonunun tanı ve tedavisi oküler rahatsızlık semptomları olan protez göz kullanıcılarında şikâyetleri azaltabilir.

Anahtar Kelimeler: Kuru göz sendromları; meibomian bez; protez göz
ABSTRACT
 Objective: We aimed to investigate whether meibomian gland dysfunction is the cause of ocular discomfort in patients wearing prosthetic eyes and to evaluate the effect of prosthetic eyes on meibomian gland. Material and Methods: Twenty-four patients wearing prosthetic eyes were included in the study. Meibomian gland morphology of both eyes was evaluated by meibography (Cirius, CSO, Italy). The loss of meibomian glands was evaluated as Stage 0 (no loss), Stage 1 (<25%), Stage 2 (25%-50%), Stage 3 (50%-75%) and Stage 4 (>75%). Inferior tear meniscus parameters were measured by optical coherence tomography (Optovue, Inc., Fremont, USA). The lid margin abnormalities were examined with a slit lamp biomicroscopy. The patients were asked to fill out a questionnaire evaluating ocular symptoms. Results: Fifthy percent of the patients were female and the mean age of the patients was 52.5±16.8 (18-87) years. The upper lid meiboscore was 2.4±0.50 (2-3), in prosthetic eye and 1.50±0.58 (1-3), in healthy eye, which was higher in prosthetic eye (p<0.001). There was no difference between groups in terms of lower lid meiboscore and tear meniscus height (p=0.07, p=0.90 respectively). Tear meniscus depth and tear meniscus area were found to be higher in prosthetic eyes (p=0.009, p=0.02, respectively). Ocular symptom score was found to be higher in those who wore prosthetic eyes for more than 10 years (p<0.001). Conclusion: Compared to healthy eyes, patients wearing prosthetic eyes have significant meibomian gland loss in the upper eyelids. Diagnosis and treatment of meibomian gland dysfunction can alleviate symptoms in prosthetic eye wearers with symptoms of ocular discomfort.

Keywords: Dry eye syndromes; meibomian gland; prosthtetic eye
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