Evaluation of tear film and the morphological changes of meibomian glands in young Asian soft contact lens wearers and non-wearers

Abstract

Background The aim of this study was to explore the differences in terms of tear film and meibomian glands (MGs) between young Asian soft contact lens (CL) wearers and non-wearers. Methods A prospective, cross-sectional observational study was conducted using 148 subjects (63 non-wearers, and 85 soft CL wearers who had been wearing CLs for more than 1 year) recruited from a clinic in Tianjin, China. All subjects first responded to an Ocular Surface Disease Index (OSDI) questionnaire and then underwent a standardized dry eye examination, which included measuring tear meniscus height (TMH), non-invasive tear breakup time (NIBUT), and corneal fluorescein staining (CFS). The MGs were evaluated via ImageJ, distorted MG count and the MG dropout were recorded. Results Compared to the control group (non-wearers), the CL group recorded higher OSDI and CFS scores, lower TMH and NITBUT values, a larger distorted MG count, and larger MG dropout (all P < 0.05). Pearson correlation analysis found a correlation between MG dropout and the duration of CL use (r = 0.440, P < 0.001), OSDI (r = 0.298, P = 0.006), and CFS scores (r = 0.442, P < 0.001). Conclusion CL wearers showed higher MG dropout and reduced TMH and NITBUT, which likely contributes to severe CL-related dry eye symptoms. CL use may lead to a higher MG dropout rate, and the extent of the MG dropout presumably influences the tear film status in CL wearers.

BCLA CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye

“…There was no significant difference in average Meibomian gland dropout between rigid corneal lens wearers and hydrogel lens wearers [63]. Another, more recent study which also evaluated the effect of contact lens wear on Meibomian glands in an Asian population supports these findings in that contact lens wear negatively affects Meibomian glands and, furthermore, the structural changes worsen with years of wear [65]. Other researchers have also reported apparent changes to Meibomian glands related to contact lens wear [66,67].…”

“…In addition, there was no difference in pre-lens tear break-up time between symptomatic or asymptomatic groups [82]. Many other studies have shown that subjective symptoms are related to contact lens wear [57,61,65,66,72] but on the other hand, there are also some that did not observe this relation [59,60,71,83,84]. The influence of overnight orthokeratology (ortho-k) on Meibomian glands has also received some attention in the literature.…”

BCLA CLEAR - Contact lens complications

“…CLIDE may also be associated with increased meibomian gland drop out [316,317], plugged gland orifices [318] or altered meibomian gland function (MGD) [319] (see Section 9). It may contribute to changes in lipid layer thickness and integrity [320], tear instability and decreased lens wettability due to a buildup of lipid deposits on the contact lens surface [321].…”

“…-Meibomian gland expression -Meibomian gland imaging (infrared Meibography, Spectral domain, OCT, and confocal microscopy Increased meibomian gland morphological changes and drop-out [316,317,319].…”

Assessment of meibomian gland drop-out and visibility through a new quantitative method in scleral lens wearers: A one-year follow-up study

“…This disease was defined by the 2011 International Workshop on MGD as "a chronic, diffuse abnormality of the Meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion" [15]. Some studies concluded that soft and rigid contact lens wear may potentiate meibomian gland drop-out, alter gland morphology such as length and width, alter meibum expressibility and quality, and induce dry eye symptoms, ultimately classified as MGD [22][23][24][25][26][27][28].…”