Abstract: Objective To investigate the morphology correlation between palpebral margins and meibomian glands in patients with meibomian gland dysfunction (MGD) based on the established morphology scoring system. Design Cross-sectional study. Participants A total of 30 MGD patients before Lipiflow heat pulse treatment in Tongren Hospital were classified and included. Methods The meibomian glands were photographed using the Keratograph 5M, and the eyelid margins were photographed using an anterior segment bioslit lamp microscope. The lid margin abnormalities were recorded: oriflces, Marx line, quality of exPressed excreta, rounding of lid margin, vascularity, telanglectasia and irregularity. The meibomian glands abnormalities were recorded: dropout, white patches, cystoid dilation, atrophy, tortuous and bifurcation. White patches refer to the hyper reflexive changes in meibomian glands taken by oculus keratgraph 5M which may indicate possible acinar changes and aging changes. Oriflces was graded as normal circular oriflces, capping in the oriflces, pouing in the oriflces and epithelial plugging in the oriflces. Morphological scores were calculated by the morphological classification methods. This cross-sectional study was figured out correlations by Spearman to calculate the P values. Main Outcome Measures The scores of lid margins and meibomian glands morphological characters, the correlation coefficient (r) of lid margins and meibomian glands morphologies. Results There was a positive correlation between meibomian gland opening morphology and secretion characteristics (r=0.590, P=0.001). There was a positive morphology correlation between the calcification and the openings of meibomian glands (r=0.439, P＝0.015). There was a negative correlation between the atrophy or bifurcation and the secretion traits of the meibomian glands (r=-0.349, -0.374，P=0.048, 0.042). Other items were not correlated. In the palpebral margin morphologies, the correlation between the keratinization scores and the total scores of the palpebral margins was the strongest (r=0.842，P=0.000). There was a significant positive correlation between the keratinization and the morphological changes of the meibomian glands openings (r=0.517, P=0.003). In the meibomian gland morphology, the correlation between the calcification scores and the total meibomian gland scores was the strongest (r=0.535, P=0.002). Conclusion There were morphological correlations between meibomian glands and lid margins. For morphological assessment of MGD patients, white patches were more reasonable for the assessment of meibomian glands. Telanglectasia was more reasonable for the assessment of lid margins, which is associated with the changes of the meibomian gland openings. (Ophthalmol CHN, 2020, 29: 355-360）

Key words: meibomian gland dysfunction, palpebral margin morphology, meibomian gland morphology