Anterior segment optical coherence tomography, tear meniscus, and meibography in daily disposable versus monthly replacement soft contact lens users

Abstract: PURPOSE: To compare meibomian gland (MG) structure and tear meniscus metrics among daily disposable single-use and monthly replacement (daily-wear, no overnight) soft contact lens (CL) wearers and nonwearing controls. METHODS: Ninety-eight young adults were enrolled: 33 daily disposable (single-use) CL wearers, 31 monthly replacement (daily-wear; no overnight) wearers, and 34 nonwearing controls. All assessments were performed off-lens in the left eye. Tear meniscus height, tear meniscus depth, and tear meniscus area were measured with anterior segment optical coherence tomography. Noninvasive tear break-up time (NIBUT) was recorded, and MG morphology (meiboscore, partial loss, dropout, tortuosity, and thickening) was graded using noncontact meibography. Ocular symptoms were assessed with the Ocular Surface Disease Index (OSDI). RESULTS: Groups were similar in age, screen time, refraction, NIBUT, and tear meniscus parameters (all P > 0.05). OSDI scores differed significantly ( P = 0.016). Compared with controls, CL wearers showed higher upper- and lower-lid meiboscores (both P < 0.001), with monthly users exhibiting more lower-lid partial loss ( P = 0.008) and dropout ( P = 0.013). Total meiboscore differed among groups ( P < 0.001). CONCLUSION: CL wear is linked to MG structural changes and more symptoms, despite similar tear volume/stability. Monthly CL use may cause greater MG disruption. Routine MG assessment and lower-exposure strategies (e.g., daily disposable lenses) may benefit at-risk users. Longitudinal, material-controlled studies are needed.