The effects of facial mask use on ocular surface parameters and tear film cytokine profile in prolonged use

Abstract

Objective To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings. Methods In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD). Results In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex ( p > 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. ( p > 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 ( p = 0.036 and p = 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups ( p > 0.05). Conclusions Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.

Comparing automated and manual assessments of tear break-up time using different non-invasive devices and a fluorescein procedure

“…Two different experiments were carried out to evaluate the NIBUT assessment of Sirius+, a recently developed Placido-based topographer integrated with a Scheimpflug tomographer. Even though its clinical application has been already reported in the literature 41 – 44 , no data about its level of agreement with other devices/procedures, and repeatability is available. To clarify the discussion of the results obtained in the two experiments, the outcomes have been divided into specific paragraphs.…”