Meibomian Gland Dysfunction in Type 2 Diabetic Patients

PURPOSE To investigate meibomian gland and tear film function in patients with type 2 diabetes. METHODS This prospective study compared changes in meibomian gland and tear film function in type 2 diabetic patients with nondiabetic patients. Meibomian gland function was evaluated by measuring lipid layer thickness (LLT), grading of meibomian gland loss, lid margin abnormalities, and expression of meibum. Tear film function was assessed by measuring tear breakup time (TBUT), the Schirmer I test, noninvasive breakup time (NIBUT), tear meniscus height (TMH), and corneal fluorescein staining. RESULTS Meibography scores were significantly higher in the diabetic group compared with the nondiabetic group (p = 0.004). The number of expressible glands was significantly lower in the diabetic group in temporal, central, and nasal third of the lower eyelid (nasal: p = 0.002; central: p = 0.040; and temporal: p = 0.039). The lid margin abnormality score was significantly higher in the diabetic group than in the nondiabetic group (p = 0.04). There was no statistically significant difference in the tear film function parameters between the two groups. CONCLUSIONS Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. Overall, most of the diabetic patients manifest as having asymptomatic MGD.