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Ophthalmology. 2018 Aug;125(8):1181-1188. doi: 10.1016/j.ophtha.2018.01.025. Epub 2018 Feb 16.

Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye.

Author information

1
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
2
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Electronic address: motoko-k@a3.keio.jp.
3
Department of Ophthalmology, Kyorin University, Tokyo, Japan.
4
Department of Japan Medical Affairs, Santen Pharmaceutical Co., Ltd., Osaka, Japan.
5
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
6
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Abstract

PURPOSE:

To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED).

DESIGN:

Cross-sectional observational study.

PARTICIPANTS:

This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6±15.7 years [range, 21-90 years]) for analysis.

METHODS:

Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated.

MAIN OUTCOME MEASURES:

Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score.

RESULTS:

We classified the participants into aqueous-deficient dry eye (ADDE; n = 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n = 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97±1.02 seconds; MGD absent, 2.94±1.63 seconds [P < 0.001]; ADDE/MGD present, 1.94±1.08 seconds; ADDE/MGD absent, 2.77±1.61 seconds [P < 0.001]; short TBUT-DE/MGD present, 2.07±0.97 seconds; short TBUT-DE/MGD absent, 2.94±1.23 seconds [P = 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08±1.39 seconds; ADDE/FRD absent, 2.92±1.54 seconds; P < 0.001).

CONCLUSIONS:

This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype.

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