Association between recurrent corneal erosion syndrome and Demodexinfestation or meibomian gland dysfunction

Objective

To investigate the effect of Demodex palpebralis infestation and meibomian gland dysfunction(MGD) on the incidence of recurrent corneal erosion syndrome (RCES).

Methods

A case-control study was performed.Thirty eyes of 30 RCES patients were enrolled from January to June 2018 in Hanyang Hospital of Wuhan Aier Eye Hospital, and served as the RCES group.Thirty-one eyes of 31 simple ametropia patients with matched age and gender were enrolled at the same time and served as the control group.Eyelash microscopic examination was performed for Demodex counting, slit-lamp examination was performed to observe the condition of meibomian gland.Keratograph 5M examination was performed to detect the morphological changes in the meibomian glands.This study was approved by the Ethics Committee of Wuhan Aier Eye Hospital.All subjects were aware of the method and purpose of this study.

Results

The average meibomian glands score was 4(3, 4) in the RCES group, which was significantly higher than 2(1, 3) in the control group (Z=-4.55, P=0.00). The average meibomian gland secretion score was 15.5(11.0, 16.8) in the RCES group, which was significantly higher than 8.0(5.5, 10.0) in the control group (Z=-3.97, P=0.00). The average Demodex numbers was 8(4, 9) and 0(0, 2) in the RCES and control groups, respectively, with a significant difference between them (Z=-4.13, P<0.00). The average Demodex infection rate was 83.3% (25/30) and 38.7% (12/31) in the RCES and the control groups, respectively (χ²=7.60, P<0.01). The recurrence frequency showed a positive correlation with the meibomian glands scores (r_s=0.70, P<0.01), meibomian gland secretion scores (r_s=0.47, P=0.04) and Demodex numbers (r_s=0.73, P<0.01).

Conclusions

The infection rate of Demodex palpebralis and the degree of MGD are obviously elevated in RCES patients, and are associated with the relapse frequency of RCES.