Morphological and Functional Assessment of Meibomian Glands in Keratoconus

Abstract

Purpose: To evaluate the morphology and function of the meibomian glands (MG) in keratoconus patients.Methods: One hundred eyes of 100 keratoconus patients and 100 eyes of 100 age-matched healthy subjects were included into this study. Ocular Surface Disease Index (OSDI) scores, non-invasive break up time (NIBUT), meibography findings, fluorescein staining of the ocular surface, tear film break-up time (TBUT), and Schirmer I test were recorded in all patient eyes and were compared with controls.Results: The mean TBUT and NIBUT were significantly lower, corneal staining and OSDI scores were statistically higher in the keratoconus group (p<0.05). The mean meiboscore, partial gland, gland dropout and gland thickening scores of the upper and lower eyelids were significantly higher in keratoconus patients compared to controls (p<0.05). The NIBUT measurements significantly correlated with MG loss in both upper and lower eyelids (p<0.05). The severity of keratoconus seemed to correlate with meiboscore, partial gland, gland thickening scores in both upper and lower eyelids. Conclusion: Our data suggest that corneal ectasia in keratoconus is associated with alterations in ocular surface, tear film function and MG morphology. Early screening and treatment of MG dysfunction may improve ocular surface quality and allow better disease management in keratoconus patients.