Evaluation of meibomian gland morphology in keratoconus patients wearing scleral contact lenses

We aimed to evaluate the morphological changes in meibomian glands in keratoconus patients using scleral contact lenses and compare them with keratoconus and healthy controls.

The study included 34 eyes of 20 patients who were wearing scleral contact lenses due to keratoconus, as well as 31 age- and sex-matched keratoconus controls and 31 healthy controls. Slit-lamp biomicroscopy, non-invasive tear film break-up time assessment, Schirmer I test, meibography, and corneal staining with fluorescein were performed. Subjective symptoms were assessed using the Ocular Surface Disease Index.

In this study, the lower and upper percentage meibomian gland loss was statistically higher in the scleral contact lens group than in the keratoconus and healthy control groups (p < 0.001 and p = 0.013, respectively). There was a positive correlation between scleral contact lens wear duration and the lower eyelid percentage meibomian gland loss and upper eyelid gland curling scores (rho: 0.396; p = 0.021 and rho: 0.344; p = 0.047, respectively). The lower and upper eyelid percentage meibomian gland loss, and upper eyelid gland curling values were higher, and the Schirmer 1 values were found to be lower in patients who used scleral contact lenses for more than three years than those who wore them less than three years.

In patients using scleral contact lenses for more than three years, meibomian gland curling values and percentages of meibomian gland loss in both eyelids are higher.