A review of the literature on meibomian gland health (MG) and contact lens (CL) use shows “conflicting relationships,” and the need for future longitudinal studies with standardized clinical meibomian gland assessments — and until those are performed, CL wearers should have a full MG evaluation, “especially because recent data suggest that meibomian gland treatments may restore meibomian gland structure and function,” according to a study published in Contact Lens & Anterior Eye.
Researchers conducted a PubMed.gov literature search conducted on or before May 15, 2021, searching for “meibomian gland(s)” plus “contact lens(es)” or “meibography” plus “contact lens(es).” Only articles available as full text and written in English were included. Articles had to discuss the impact of contact lenses on MG morphology or function. Grading was performed according to the level of evidence presented.
The study authors used reference lists in recovered papers to find articles they missed in their primary search. They found that the literature points to the fact that contact lenses impact MG function, but the data are “equivocal” regarding contact lenses inducing MG structural changes.
“The literature likewise indicates that the mechanism(s) by which contact lenses impact the MGs are likely multifactorial. Recent data suggests that MGs may have some plasticity. Detected differences between studies likely stem from varied populations evaluated, study designs, and the duration of the evaluation periods,” according to the report.
“Considering the limitations … in comparing the study results presented in this paper, it is clear that standardization of MG evaluation techniques and general study design is important for moving this field forward,” the study explains. “Technology and techniques evaluating MG structure and function continue to improve and become more accessible to both researchers and clinicians, so now is an opportune time to establish standardized protocols and evaluation techniques that allow more reliable comparisons of various investigations. Standardized protocols for MG evaluations beyond the Dry Eye Workshop (DEWS) II Report should be developed to allow for better comparison between study results and to move the field forward to a consensus.”
They add that when their article was published in December 2021, no well-designed, randomized clinical trials have yet looked at MG function with CL wear, which should be remedied in the future with this type of research.
Rueff EM, Tichenor AA, Ngo W, Pucker AD. A review of meibomian gland structure, function, and contact lens wear. Cont Lens Anterior Eye. 2021:101560. doi:10.1016/j.clae.2021.101560