Authors: Liu Zhuzhu, Wei Ruihua, Wang Di, Wang Xiu, Zhang Rui
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To explore the relationship between contact lens (CL) related dry eye and morphological changes of meibomian glands.
A cross-sectional study was performed.A total of 157 consecutive subjects (314 eyes) to underwent refractive surgery from May 2014 to June 2015 in Tianjin Medical University Eye Hospital were included.The subjects wearing soft CL for a long time were divided into CL group (182 eyes of 91 subjects), while the subjects who never wore CL were divided into the control group (132 eyes of 66 subjects). The ocular surface disease index (OSDI) questionnaire, tear meniscus height (TMH), first non-invasive tear film breakup time (fNIBUT), average non-invasive tear film breakup time (avNIBUT) and corneal fluorescein staining (CFS) score of all subjects were collected and analyzed.Morphological evaluation of meibomian glands were performed.The meibomian glands dropout ratio of upper eyelid, lower eyelid and total meibomian gland area as well as meibomian glands distortion number of the two groups were compared.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2014KY[L]-09). Written informed consent was obtained from each patients prior to any examination.
The OSDI score, CFS score, TMH, fNIBUT and avNIBUT were 16.67(10.00, 25.00), 13.88(7.50, 18.26), 0.20(0.17, 0.23) mm, 5.64(3.95, 7.92)s and 8.56(6.56, 12.12)s in CL group, respectively, while 13.88(7.50, 18.26), 1.00(0.00, 2.00), 0.22(0.17, 0.29) mm, 7.33(4.54, 13.21)s and 11.49(7.46, 17.83)s in the control group, respectively.Compared with the control group, the CL group had the higher OSDI score, higher CFS score, lower TMH, lower fNIBUT, lower avNIBUT, and the differences were significant (all at P<0.01). The MG dropout ratio and meibomian gland distortion number were (29.42±12.24)% and 4(3, 6) in CL group, respectively, while (20.37±10.83)% and 3(1, 4) in the control group, respectively.In comparison with the control group, the CL group had the higher MG dropout ratio and greater meibomian gland distortion number (t=6.76, P<0.01; U=7 656.00, P<0.01). A positive correlation was found between the total meibomian gland area dropout ratio and duration of CL wearing (rS=0.404, P<0.01), OSDI scores (rS=0.275, P<0.01), CFS scores (rS=0.319, P<0.01).
Long-term wearing of CL can lead to severe ocular discomfort, dry eye syndrome and morphological alterations in meibomian gland, suggesting that morphological abnormality of meibomian gland is presumably associated with the occurrence of ocular discomfort and dry eye syndromes in CL wearers.
Dry eye; Contact lens; Meibomian gland; Tear film; Keratograph 5M