Purpose
Meibum from donors who have had hematological stem cell transplantations (M
HSCT
) are susceptible to severe dry eye symptoms and exhibit very high lipid order (stiffness) compared with meibum from donors without dry eye (M
n
). Since lipid order could have functional consequences, we compared the rheology and composition of M
n
and M
HSCT
to measure meibum compositional, structural and functional relationships.
Methods
The rheology and composition was measured using Langmuir trough and
1
H NMR spectroscopy, respectively.
Results
M
HSCT
and M
n
was studied from 16 to 43 donors, respectively, using NMR spectroscopy. M
HSCT
contained significantly 16% more straight chain and 24% less iso-chain hydrocarbons compared with M
n
. The cholesteryl ester to wax ester molar ratio, and hydrocarbon chain unsaturation were not significantly different, for M
HSCT
compared with M
n
.
Surface pressure-area isotherms of meibum from 30 donors without dry-eye were grouped into 4 pools (PC) and meibum from 32 donors with dry eye who had hematopoietic stem cell transplantation (PT) were grouped into 3 pools. Above 15 years of age the П
max
and (C
s
−1
)
max
increased with age for both the PC and the PT cohorts. (C
s
−1
)
max
values were higher for PT samples compared with age matched PC samples, indicating they had higher elasticity and stiffness. A more ordered lipid could contribute to the formation of a discontinuous patchy tear film lipid layer, which in turn results in deteriorated spreading, and decreased surface elasticity.
Conclusions
The composition and rheology of meibum from donors with dry eye and who have had HSCT support the idea from other studies that more ordered meibum may contribute to or be a marker of dry eye.