AIM: To analyze ocular wavefront aberrations and scattering parameters changes in patients with meibornian gland dysfunction(MGD)and aqueous deficient dry eye(ADDE), and assess the visual quality of patients with two types of dry eye syndromes.

METHODS:There were 25 patients with MGD, 25 patients with ADDE and 25 healthy controls treated in our hospital from January to October 2018 were included in this study. Ocular surface disease index questionnaire(OSDI)and tear film correlation examination were performed in three groups. The tear film correlation examination included tear break-up time(TBUT), Schirmer test( SⅠt )and cornea fluorescein staining(FL). The root mean square of total high order aberration(HO), comatic aberration(CA), trefoil aberration(TA)and spherical aberration(SA)were recorded with i-Trace visual function analyzer. The scattering values were recorded by the double-pass Optical Quality Analysis System(OQAS Ⅱ), including the modulation transfer function(MTF cutoff ), Strehl ratio(SR)and objective scattering index( OSI ). Three groups of subjects kept their eyes open for 20s, the mean value of OSI was recorded using OQAS Ⅱ tear film analysis program.

RESULTS:The OSDI score in MGD group was significantly higher than that in ADDE group(38.2±5.6 vs 32.2±7.2, P<0.01). The SⅠT score in ADDE group was significantly lower than that in MGD group(1.98±0.92 vs 12.52±6.80mm/5min, P<0.001). The TBUT and FL staining score were lower in MGD group than those in ADDE group(TBUT: 3.27±1.91 vs 6.02±1.05s, FL:3.27±2.18 vs 6.23±2.19, all P<0.001). There was no significant difference in HO, CA, TA and SA between MGD Group and ADDE group(HO: 0.385±0.081 vs 0.344±0.092, CA:0.210±0.062 vs 0.175±0.075, TA:0.107±0.056 vs 0.086±0.042, SA:0.322±0.078 vs 0.273±0.097, HO:t=1.67, P>0.05; CA: t=1.80, P>0.05; TA: t=1.50, P>0.05; SA: t=1.97, P>0.05). There was no statistically significant differences between MGD group and ADDE group with the value of MTF cutoff, SR and OSI(MTF cutoff: 33.28±8.28 vs 37.12±9.53, SR: 0.19±0.06 vs 0.22±0.08, OSI:1.30±0.32 vs 1.12±0.52, MTF cutoff: t=1.52, P>0.05; SR: t=1.50, P>0.05; OSI: t=1.47, P >0.05). In the condition of not blinking, the mean value of OSI in MGD group was significantly higher than that in ADDE group(2.386±0.118 vs 1.554±0.058, P<0.001).

CONCLUSION:In the treatment of symptoms of patients with dry eye, improving the visual quality of patients should also be considered. The visual quality in patients with MGD is more serious than those with ADDE. The OSI related parameters seem to be sensitive indicators indexes to evaluate the dynamic changes of tear film-related visual quality in dry eye patients.