The effect of mask usage on dry eye symptoms and meibomian gland function in OSAS patients: an observational study.

Objective: To analyze the effect of mask usage on dry eye symptoms and meibomian gland function in patients with obstructive sleep apnea syndrome (OSAS).

Methods: OSAS patients who visited our hospital from January 2022 to December 2023 were selected as research subjects. All patients were treated with continuous positive airway pressure (CPAP) therapy. The polysomnography (PSG) results before and after treatment were analyzed, including the apnea-hypopnea index (AHI) and peripheral oxygen saturation (SpO₂). Dry eye conditions and ocular surface analyzer results of patients before and after treatment were evaluated. Pearson correlation was used to assess the relationship between dry eye conditions and ocular surface analyzer results in OSAS patients, and the correlations between PSG results and dry eye conditions as well as ocular surface analyzer results were also analyzed.

Results: AHI levels in 31 OSAS patients were significantly decreased after treatment, while SpO₂ levels significantly increased, with a statistically significant difference (P<0.05). After treatment, the tear breakup time (BUT), palpebral (PL) scores, and Ocular Surface Disease Index (OSDI) scores of patients were significantly higher than those before treatment (P<0.05). Additionally, after treatment, the tear meniscus height of OSAS patients was significantly lower than that before treatment, and the lipid layer thickness and eye redness index were significantly higher than those before treatment, with a statistically significant difference (P<0.05). The results of Pearson correlation analysis showed that BUT was positively correlated with lipid layer thickness and eye redness improvement, while Schirmer's test (Sit) was positively correlated with tear meniscus height. PL scores were negatively correlated with tear meniscus height but positively correlated with the eye redness index (P<0.05). AHI from PSG results was negatively correlated with BUT, PL scores, and OSDI scores (P<0.05), while SpO₂ was positively correlated with BUT, PL scores, and OSDI scores but negatively correlated with Sit (P<0.05). In the PSG results, AHI was negatively correlated with lipid layer thickness and eye redness index, and positively correlated with meibomian gland opening score (P < 0.05).

Conclusion: CPAP mask usage in OSAS patients may negatively impact dry eye symptoms and meibomian gland function, leading to decreased tear film stability and worsening symptoms of eye dryness.