[Research on the impact of lid margin tattooing on the morphology and function of the ocular surface and meibomian glands].

Objective: To investigate the impact of eyeliner tattooing on the ocular surface, the morphology and function of meibomian glands, and to explore its potential influence on ocular surface health. Methods: A retrospective cohort study was conducted. A total of 31 female subjects (62 eyes) with eyeliner tattoos who visited the outpatient department of Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University from April to September 2022 due to visual fatigue and other reasons were included as the eyeliner group, and 28 age-matched female subjects (56 eyes) without eyeliner tattoos were included as the control group. Questionnaires, tear meniscus height measurement, evaluation of the distance between meibomian gland imaging and the eyeliner, detection of the thickness of the lipid layer of the tear film and blink parameters, tear secretion test and tear film break-up time(BUT) measurement, meibomian gland function score and other examinations were carried out for all subjects. The main indicators included the Ocular Surface Disease Index (OSDI) score, tear meniscus height (TMH), lipid layer thickness of the tear film, tear secretion test, and BUT, etc. Results: The OSDI score of the eyeliner group was (43.05±19.00) points, which was significantly higher than that of the control group [(20.70±12.42) points] (P<0.05). The TMH of the eyeliner group was (0.19±0.06) mm, and the BUT was (4.19±1.28) s, both of which were lower than those of the control group [(0.31±0.16) mm and (5.64±2.16) s], and the differences were statistically significant (both P<0.05). The scores of meibomian gland loss degree, meibomian gland secretion, and meibomian gland excretion ability in the eyeliner group were all significantly higher than those in the control group (all P<0.05). In addition, the proportion of incomplete blinks in the eyeliner group was significantly higher than that in the control group (P<0.05). The distance between the eyeliner and the opening of the meibomian gland was positively correlated with the scores of meibomian gland loss degree and meibomian gland excretion ability (r=0.432, 0.539; both P<0.05). Conclusion: Eyeliner tattooing has a significant impact on the ocular surface and the morphology and function of meibomian glands, resulting in an increase in the OSDI score, a decrease in the TMH and BUT, a decline in meibomian gland function, and an increase in the proportion of incomplete blinks, which may increase the risks of ocular discomfort and dry eye.