AIM:To investigate the characteristic changes of ocular surface and meibomian gland function after strabismus in adolescents and analyze the related influencing factors.

METHODS:Retrospective study. Totally 168 cases(224 eyes)with strabismus surgery in our hospital from January 2019 to December 2019 were selected as the study objects. According to the surgical incision, all patients were divided into the limbal incision group(group A, 54 cases, 78 eyes), trans-muscular terminal-incision group(group B, 48 cases, 62 eyes), and near-fornix incision group(group C, 66 cases, 84 eyes). Based on the number of muscles involved in the operation, patients were divided into single extraocular muscle group(68 eyes), the double extraocular muscle group(106 eyes)and three extraocular muscle group(50 eyes). The children's eye surface health were evaluated. Other eye index such as lipidlayer thickness(LLT), tear meniscus height(TMH), corneal fluorescence staining score(CFSS), tear film break up time(TBUT), tear secretion(SⅠt), and meibomial gland opening were analyzed by Lipiview eye surface interferometer.

RESULTS:The eye surface and meibomian gland function presented no significant difference in groups after surgery 1wk. Postoperative 1mo, ocular surface and muscle operating meibomian gland function were improved significantly(P<0.05), which TBUT in group B was obviously higher than that of group A(P<0.05), and OSDI, CFSS, TBUT in group C were significantly better than that of group A(P<0.05). TMH of children in two groups was significantly higher than that of a single group(P<0.05), three children OSDI is higher than a single extraocular muscle group(P<0.05). Three month after surgery, the children with ocular surface and meibomian gland function were compared with postoperative 1wk and 1mo improved significantly(P<0.05). Among them, the OSDI, LLT, TMH, CFSS, TBUT and SⅠt of children in C group were significantly better than that of group A(P<0.05). And TMH, CFSS, SⅠt and meibomian gland orifices in other two groups were better than that of group A(P<0.05), double extraocular muscle group and three extraocular muscle group of children with meibomian gland orifices were lower than single extraocular muscle group(P<0.05). OSDI, CFSS and meibomian gland orifices score of children had significantly correlation with the surgery involving muscle number(P<0.05).

CONCLUSION:Ocular surface and meibomian gland function recovery of children in the fornix incision group were better than that of corneal limbus incision group and across muscle check incision.The ocular surface and meibomian gland function recovery of children with single set were also better than that of children with two and three.Thus,taking nearly fornix incision and decreasing the number of the surgery involving the muscles was helpful to ocular surface and meibomian gland function recovery in the youth eye strabismus surgery.