The role of Meibomian glands on the development of dry eye disease in patients with unilateral pseudoexfoliation

Abstract

To evaluate the Meibomian glands and presence of dry eye in patients with unilateral pseudoexfoliation. The study included 32 patients with clinical pseudoexfoliation (PEX) in one eye and 30 controls. Schirmer and tear film break-up time (TBUT) tests were performed, along with a detailed ophthalmological examination, meibography and evaluation of areas of meibomian gland loss. Subjective symptoms were evaluated using the ocular surface disease index (OSDI). Schirmer test results for eyes with or without PEX were similar (10.438±4.47mm and 11.563±4.35mm, respectively), vs. 15.967±9.75mm in the control group. While measurements of TBUT were found to be similar in both eyes of the patient group (6.188±2.66s in eyes with PEX and 6.250±1.87s in eyes without PEX), this was 8.233±2.66s in the control group. Schirmer and TBUT test results were found to be significantly lower in both eyes of patients with unilateral pseudoexfoliation compared to control eyes. The rate of meibomian gland loss in the upper and lower eyelids in the patient group was found to be significantly higher than in the control group. Similarly, meiboscores of both eyelids in the control group were significantly lower than those in patient group; however, there were no differences between patient eyes with or without pseudoexfoliation. The patients with unilateral pseudoexfoliation had a significant loss of meibomian gland area in both eyes compared to the control group, and their meiboscore was higher. It should be considered that meibomian gland loss may be one of the causes of dry eye in patients with pseudoexfoliation.