Tear Film Function and Lipid Composition of Meibomian Glands

Purpose: To determine the preocular tear film function and lipid composition of meibomian gland secretion of patients with acne rosacea. Material and Methods: Twenty one patients diagnosed as acne rosacea and 17 age-matched controls were included in this study. These acne rosacea patients were examined in two groups; the first group had 8 patients who were taking oral doxycycline and the second group had 13 patients who did not get any treatment. Tear film functions were determined by Schirmer 1 and fluorescein break-up time (BUT) tests. Meibomian secretions were obtained from each eye and analyzed by gas-chromatography/mass-spectrometry. Results: Acne rosacea patients had significantly higher frequency of dry eye symptoms and lid collarette. The tear film meniscus height and the quality of meibomian gland secretion were significantly reduced in the nontreatment group. Acne rosacea patients in nontreatment group had significantly lower Schirmer 1 (left eye) test and BUT test values. In lipid analysis diglycerides and unsaturated free fatty acids were significantly higher, triglyceride and cholesterol levels were lower in the nontreatment group, relative to treatment and control groups. Conclusion: In acne rosacea, the patients have dry eye symptoms due to insufficient tear production and evaporative tear loss. This study shows that meibomian gland lipid composition changes in these patients. And with the use of oral doxycyline meibomian lipid composition converts back to normal which results in improvement in preocular film stability and improvement in dry eye symptoms.