Association of Ocular Surface and Meibomian Gland Alterations with Silicone Hydrogel Contact Lens Wear

Purpose: To evaluate silicone hydrogel contact lens (SH-CL) effects on the meibomian glands, corneal structure, and ocular surface parameters. Methods: Fifty SH-CL wearers for at least 6 months, and 50 sex and age-matched control subjects were recruited for this cross-sectional study. Visual display terminal (VDT) work and CL wear duration were questioned, ocular surface and tear functions were evaluated using OSDI questionnaire, tear break-up time (TBUT), corneal fluorescein staining, and Schirmer test. Corneal sensitivity was measured with Cochet-Bonnet aesthesiometry. Meibography and in vivo confocal microscopy (IVCM) were performed to evaluate meibomian glands and corneal structure. Intergroup comparisons were made using the Chi-square test, Wilcoxon test, or Kruskal–Wallis test. Results: In the CL group, TBUT was shorter (P=0.01), corneal fluorescein staining (P=0.04), OSDI scores (P<0.001), and meiboscores (P<0.001) were higher than the control group. The biomicroscopic evaluation revealed meibomian gland dysfunction (MGD) in 34% of the CL group and 20% of the control group, which was not statistically significant (P>0.05). IVCM showed that endothelial cell density was lower (P=0.01) and polymegethism was higher (P0.05). The longer VDT work duration was associated with increased CFS in the CL group (P=0.05). Conclusion: The results showed that SH-CL wear increased DED symptoms, especially in longer VDT work duration. Meibography revealed significantly worse results in SH-CL wearers. SH-CL-related DED seems to be more associated with MGD rather than neurosensorial alterations.