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Assessment of Meibomian Gland Function in Dry Eye Using Meibometry
Norihiko Yokoi, MD, PhD;
Federico Mossa, MD;
John M. Tiffany, PhD;
Anthony J. Bron, FRCOphth
Arch Ophthalmol. 1999;117:723-729.
Objective To study meibomian gland function in dry eyes using meibometry.
Methods Forty-two patients with clinically diagnosed dry eye that was reclassified as meibomian gland dysfunction (MGD [n=12]), aqueous-tear deficiency (AD [n=10]), MGD combined with AD (n=2), "incomplete" dry eye (n=12), and non–dry eye (6 eyes) were compared with 41 healthy control subjects. The following 2 techniques of meibometry were applied: direct meibometry (DM) measuring lipid imprints using the Meibometer, and integrated meibometry (IM) using image-scanning and computer densitometry. Tear film lipid layer thickness was assessed using interference microscopy.
Results Imprints were homogeneous for all subjects except those with MGD. Mean ± SE readings on results of DM were 127.24 ± 24.4 for MGD, 306.4 ± 9.2 for AD, 248.6 ± 13.2 for incomplete dry eye, and 268.5 ± 6.3 for controls, showing lower values in the MGD group relative to all others (P<.001). Results of IM gave similar results (P<.001, P=.01, and P<.001, respectively). Lipid layers appeared lower for the MGD group than others.
Conclusions Compared with controls, lid lipid levels are reduced in patients with MGD, and increased in women with AD. Lipid layer thickness is increased in women with AD compared with patients with MGD. Both meibometric techniques may be useful for evaluating MGD. Although DM requires special equipment (the Meibometer), it provides a record of immediate diagnostic value. Although IM is less effective than DM, it offers visual documentation of the lipid imprint, which may itself be of diagnostic value, and uses equipment available in many laboratories.
From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (Dr Yokoi), and Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, England (Drs Mossa, Tiffany, and Bron). The authors do not have any commercial or proprietary interest in any product or company discussed herein.
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