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Ocular Surface, Meibomian Gland Alterations, and In Vivo Confocal Microscopy Characteristics of Corneas in Chronic Cigarette Smokers

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Abstract

Purpose

To evaluate the ocular surface, meibomian gland alterations, and in vivo confocal microscopy (IVCM) parameters through correlation with nicotine dependency level (NDL) and duration of smoking (DS) in chronic smokers.

Methods

This cross-sectional study included 50 eyes of 50 chronic smokers, and 50 eyes of 50 age- and gender-matched healthy nonsmokers. To examine the ocular surface and tear film, corneal sensitivity (CS) measurement with Cochet-Bonnet esthesiometer, tear film break-up time (TBUT), lissamine green (LG) staining, Schirmer I test with anesthesia, and Ocular Surface Disease Index (OSDI) questionnaire were performed consecutively. Basal epithelial cell, keratocyte, and endothelial cell density, the percentage of endothelial polymegethism/pleomorphism, and subbasal nerve plexus were evaluated using IVCM. Meibomian gland density was evaluated with a meibography unit. The Fagerström test was used to measure NDL, and DS was recorded.

Results

In the chronic smokers group, the basal epithelial cell density, anterior and posterior keratocytes, endothelial cell density, and long and total subbasal nerve numbers were lower, and LG staining, meiboscore, and OSDI scores were higher, compared with the control group, whereas other parameters were similar. The percentage of polymegethism was higher and the percentage of pleomorphism was lower in the chronic smokers group. In the correlation analysis, no significant relationship was found between the DS, NDL and ocular surface, and IVCM findings.

Conclusion

Decreased corneal basal epithelium, anterior and posterior keratocytes, endothelial cell density, meibomian gland density, and subbasal nerve numbers were found in chronic smokers. The results of the study show that smoking has an adverse effect on ocular surface parameters.

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Acknowledgements

This work was presented in part at the 52nd Turkish Ophthalmology Association National Congress (November 13–18, 2018, Antalya, Turkey).

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Authors and Affiliations

  1. Department of Ophthalmology, Patnos State Hospital, Ağrı, Turkey

    Abdullah Ağın

  2. Department of Ophthalmology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey

    Sibel Kocabeyoğlu & Murat İrkeç

  3. Department of Ophthalmology, Tunceli State Hospital, Tunceli, Turkey

    Dilan Çolak

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  1. Abdullah Ağın
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  2. Sibel Kocabeyoğlu
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  3. Dilan Çolak
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  4. Murat İrkeç
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Correspondence to Murat İrkeç.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of Hacettepe University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ağın, A., Kocabeyoğlu, S., Çolak, D. et al. Ocular Surface, Meibomian Gland Alterations, and In Vivo Confocal Microscopy Characteristics of Corneas in Chronic Cigarette Smokers. Graefes Arch Clin Exp Ophthalmol 258, 835–841 (2020). https://doi.org/10.1007/s00417-019-04547-0

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  • DOI: https://doi.org/10.1007/s00417-019-04547-0

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