Effects of chronic smoking on the meibomian glands

To evaluate the effects of chronic smoking on tear function tests and meibomian glands.

This prospective study included 40 volunteers with a long-term (> 5 years) cigarette smoking history (study group) and 43 non-smoking healthy individuals (control group). The symptoms of all the participants were scored using the Ocular Surface Disease Index (OSDI) questionnaire, and a detailed ophthalmological examination was performed including the tear breakup time (TBUT) and Schirmer test (with anaesthesia). The upper and lower lid meibomian glands were evaluated with meibography using the Sirius anterior segment analysis system (Sirius, CSO, Florence, Italy).

The groups showed homogenous distribution in respect of age and gender (p > 0.05). The patients in the study group were determined with 22.59 ± 17.25 packet/year cigarette usage. The mean OSDI score was 36.67 ± 21.47 in the study group and 31.65 ± 15.60 in the control group (p = 0.64). The TBUT and Schirmer test values were determined as 9.65 ± 6.14 s and 8.90 ± 4.95 mm, respectively, in the study group and 11.23 ± 5.94 s and 13.08 ± 8.61 mm in the control group (p > 0.05). In the upper lid meibography, loss of 24.68 ± 16.54% was determined in the study group and 17.87 ± 7.06% in the control group (p = 0.01). No statistically significant difference was determined between the groups in respect of the lower lid meibomian gland loss: study group 14.70 ± 8.49% versus control group 12.48 ± 6.44% (p = 0.20).

Smoking results in meibomian gland damage which may be a risk factor for dry eye. In cases of ocular surface disorders related to chronic smoking, meibomian gland damage should be taken into consideration.