目的：探讨不同脂质层厚度条件下泪膜稳定性的差异。

方法：纳入2020-06/2021-12于我院就诊的干眼患者194例384眼，应用角膜地形图仪行双眼泪河高度、首次泪膜破裂时间和脂质层厚度测量，分析不同脂质层厚度条件下双眼泪河高度、首次泪膜破裂时间的差异及其相关性。

结果：根据脂质层厚度将纳入患者(384眼)分为脂质丰富组(49眼)、脂质平衡组(27眼)、脂质轻微缺乏组(266眼)、脂质显著缺乏组(42眼)，四组泪河高度有差异(P=0.022)，首次泪膜破裂时间无差异(P=0.322)。脂质层厚度分级与泪河高度呈正相关(r_s=0.143，P=0.006)，与首次泪膜破裂时间无相关性(r_s=-0.090，P=0.083)； 泪河高度与首次泪膜破裂时间也无相关性(r_s=0.038，P=0.460)。

结论：泪膜脂质层厚度不同的干眼患者泪膜稳定性无明显差异。

METHOD: A total of 194 dry eye patients(384 eyes)admitted to our hospital from June 2020 to December 2021 were enrolled in this study. The tear meniscus height, the first tear film break-up time and lipid layer thickness were measured by corneal topographer. The tear meniscus height and the first tear film break-up time among different lipid layer thickness were compared and the correlation between them was analyzed.

RESULTS: The included patients(384 eyes)were divided into lipid rich group(49 eyes), lipid balance group(27 eyes), slight lipid deficiency group(266 eyes)and significant lipid deficiency group(42 eyes)according to the lipid layer thickness. The differences of the tear meniscus height were statistically different(P=0.022), while the differences of the first tear film break-up time were not statistically different(P=0.322). The lipid layer thickness was positively correlated with tear meniscus height(r_s=0.143, P=0.006). There was no correlation between lipid layer thickness and the first tear film break-up time(r_s=-0.090, P=0.083), nor was there correlation between tear meniscus height and the first tear film break-up time(r_s=0.038, P=0.460).

CONCLUSION: There was no significant difference in tear film stability in dry eye patients with different lipid layer thickness.