Abstract
Purpose
To investigate the association of keratoconus (KC) with meibomian gland dysfunction
(MGD) and to describe the epidemiological characteristics of MGD in this disease.
Methods
In this observational study, 120 KC patients seen in the Department of Ophthalmology
of the Complexo Hospitalario Universitario de Santiago de Compostela and 87 controls
were analyzed. The Ocular surface disease index (OSDI) questionnaire was administered
and several DED tests and an evaluation of the meibomian glands and lid margin were
performed. MGD signs and DED tests were compared between the groups. Symptoms were
further analyzed in patients and controls with and without MGD.
Results
KC was significantly associated with MGD after adjusting for age and sex [adjusted
odds ratio (ORa), 2.40]. The frequency of MGD in KC patients [59 (49.2%) KC patients and 25 (28.7%) controls
had MGD] correlated with the severity of KC (r = 0.206) (P = 0.020). Mean OSDI score in KC patients with and without MGD was 31.1 ± 24.1 and
35.2 ± 26.0 (P = 0.326), and 17.2 ± 22.7 and 13.3 ± 14.1 in controls with and without it (P = 0.366). The most common MGD signs coincided in both groups. Staining with fluorescein
(P = 0.000) and lissamine green (P = 0.019) was higher in KC patients, but no differences were detected with TBUT (P = 0.116) or the Schirmer test (P = 0.637). Hypersecretory MGD was the most prevalent variant in both groups.
Conclusions
MGD and DED are common in KC patients. MGD correlates with the severity of KC and
is indistinguishable from MGD in patients without KC. No association was found with
symptoms. Patients with KC should be screened for MGD because of its possible clinical
implications. Further research is needed to clarify the role of MGD in KC patients.
Keywords
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Article info
Publication history
Published online: July 27, 2021
Accepted:
July 20,
2021
Received in revised form:
July 17,
2021
Received:
October 28,
2020
Identification
Copyright
© 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
