Purpose

To determine how Meibomian gland (MG) morphology affects MG function by means of gland expression with the effect of treatment.

Methods

Fifteen patients (aged 31.6 ± 13.1 years) from a dry eye clinic diagnosed with MG dysfunction had their 365 lower lid MGs visualised with a slit-lamp biomicroscopy. Using infrared meibography (Oculus K5m), MG length, width and tortuosity were objectively measured. Each MG was expressed and the meibum graded (0=clear fluid, 1=cloudy fluid, 2= particulate fluid, 3=inspissated, or 4 = no expression) to determine its functionality. Participants had functionality repeated each time following a sequence of a warm compress, debridement, and forcible expression after 5 min.

Results

Just over 10 % of complete length MGs gave clear expression, while about 5% did not express at all, with most expressed meibum being particulate in nature. In contrast, the majority of partial length glands gave inspissated expression (38 %), with 32 % not expressing at all. No MG of <10 % length expressed. MG gland length was correlated with gland expression (r=−0.507, p < 0.001) and MG tortuosity (r=−0.129, p < 0.001), but not MG width (r=−0.090, p = 0.167). Regardless of MG length, warm compress increased the quality of expression (p < 0.002). Debridement further improved expression in partial MGs (p = 0.003), but not forcible expression (p = 0.529).

Conclusions

Length is the key functional morphology metric of lower lid MGs. Warm compress and massage increase the quality of expression in all, but the shortest glands and patients with partial length glands also benefit from debridement.

中文翻译：

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睑板腺形态对应用治疗功能的影响

目的

确定睑板腺（MG）形态如何通过腺体表达和治疗效果影响MG功能。

方法

来自一家诊断为 MG 功能障碍的干眼诊所的 15 名患者（年龄 31.6 ± 13.1 岁）用裂隙灯生物显微镜观察了他们的 365 个下眼睑 MG。使用红外meibography（Oculus K5m），客观地测量了MG的长度、宽度和弯曲度。表达每个 MG 并对睑脂进行分级（0 = 透明液体、1 = 混浊液体、2 = 颗粒状液体、3 = 浓缩或 4 = 无表达）以确定其功能。参与者每次在热敷、清创和 5 分钟后强制表达后重复功能。

结果

超过 10% 的全长 MG 表达清晰，而大约 5% 根本不表达，大多数表达的睑脂本质上是颗粒状的。相比之下，大多数部分长度的腺体表达浓缩（38%），32% 根本不表达。没有表达长度小于 10% 的 MG。MG腺体长度与腺体表达（r = -0.507，p <0.001）和MG曲折度（r = -0.129，p <0.001）相关，但与MG宽度无关（r = -0.090，p = 0.167）。无论 MG 长度如何，热敷都能提高表达质量 ( p < 0.002)。清创进一步改善了部分 MG 的表达 ( p = 0.003)，但不是强制表达 ( p = 0.529)。

结论

长度是下眼睑 MG 的关键功能形态指标。热敷和按摩总体上提高了表达质量，但最短的腺体和部分长度腺体的患者也可以从清创中受益。