title: In vivo confocal microscopy of meibomian glands in contact lens wearers.
abstract: OBJECTIVE
  To evaluate by in vivo laser scanning confocal microscopy (LSCM) the morphologic changes in the meibomian glands (MGs) and the status of periglandular inflammation in contact lens wearers (CLWs) and to investigate the correlations between clinical and confocal findings.
  
  
  METHODS
  Twenty CLWs and 20 age- and sex-matched control subjects were consecutively enrolled. Each participant completed an Ocular Surface Disease Index questionnaire and underwent a full eye examination, including tear film break-up time, fluorescein and lissamine green staining, and Schirmer test. LSCM of the MGs were performed to determine the cell density of the mucocutaneous junction epithelium, acinar unit density and diameter, glandular orifice diameters, meibum secretion reflectivity, and inhomogeneous appearance of the glandular interstice and acinar wall.
  
  
  RESULTS
  All clinical parameters showed statistically significant differences between groups (P < 0.01, Mann-Whitney U test) except the Schirmer test. Confocal data (Mann-Whitney U test) showed significantly decreased basal epithelial cell density (P < 0.01), lower acinar unit diameters (P < 0.05), higher glandular orifice diameters (P < 0.05), greater secretion reflectivity (P < 0.01), and greater inhomogeneity of the periglandular interstices (P < 0.05) in CLWs compared with controls. The duration of contact lens wear was correlated with the acinar unit diameters (P < 0.05, Spearman).
  
  
  CONCLUSIONS
  Morphologic changes in the MGs shown by LSCM were interpreted as signs of MG dropout, duct obstruction, and glandular inflammation. A comprehensive LSCM evaluation of the ocular surface in CLWs could better clarify the role of MG dropout and eyelid margin inflammation on the pathogenesis of CL-induced dry eye.
authors.affiliation: Università degli Studi di Milano, UO Oculistica Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. eddy.villani@tiscali.it
authors.forename: Edoardo
authors.initials: E
authors.lastname: Villani
authors.forename: Gaia
authors.initials: G
authors.lastname: Ceresara
authors.forename: Silvia
authors.initials: S
authors.lastname: Beretta
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Magnani
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
authors.forename: Roberto
authors.initials: R
authors.lastname: Ratiglia
mesh_terms: D000328:Adult; D001762:Blepharitis / Q000209:etiology* / Q000473:pathology*; D002452:Cell Count; D003228:Conjunctiva / Q000473:pathology; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D015352:Dry Eye Syndromes / Q000209:etiology / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D018613:Microscopy, Confocal / Q000379:methods*; D055815:Young Adult