AIM: To investigate the changes of morphology and function of meibomian glands in patients with type 2 diabetes mellitus and its influence on the tear film.

METHODS: A total of 52 patients(104 eyes)with type 2 diabetes mellitus who came to our hospital from January 2018 to January 2020 were selected. Then they were divided into non-diabetic retinopathy group(NDR group, 31 cases with 62 eyes)and diabetic retinopathy group(DR group, 21 cases with 42 eyes)according to the fundus changes. While 38 cases(76 eyes)of diabetic-free cataract patients who treated at the same time were selected as the control group. The differences of three groups were compared with the morphology and the scores of the function of lid edge and meibomian glands, the scores of fluorescence staining of cornea, break-up time(BUT)of tear film, lipid layer thickness(LLT), blink times(BT)and partial blink rate(PBR).

RESULTS: The morphology and the scores of function of lid edge and meibomian glands, the scores of fluorescence staining of cornea were significantly higher than the control group, and the DR group was significantly higher than the NDR group(all P<0.05). The BUT in the DR group and NDR group was significantly lower than that in the control group, and the DR group was significantly lower than that in the NDR group(all P<0.05). There were differences in LLT, BT and PBR among the three groups(P<0.05). The LLT and BT in the DR group and NDR group were significantly lower than those in the control group, and PBR was significantly higher than that in control group(all P<0.05), but there was no significant difference between the DR group and the NDR group(all P>0.05). Type 2 diabetes mellitus patients with morphology abnormalities of meibomian gland have a higher incidence of abnormal tear film function.

CONCLUSION: Patients with type 2 diabetes mellitus are prone to shortening and loss of meibomian glands, which is easy to cause the dysfunction of the meibomian gland and decrease the stability of the tear film. While the patients with DR, the morphology abnormalities and dysfunction of the meibomian glands are more pronounced, and the stability of the tear film is worse.