Biophysical characteristics of the Meibomian lipid layer under in vitro conditions

Ellipsometry of human tears

PURPOSE

The outer surface layer of tears is presumably composed of lipid. The thickness of this layer is considered critical to retard evaporation. Prior thickness measurements differ widely. Advances in ellipsometry have availed more precise and accurate measurements for thin films. The range in thickness of the surface layer of tears was studied by ellipsometry to uncover the source of prior discrepancies.

METHODS

Tear surface layers of normal and dry eye subjects were measured by in-vitro ellipsometry. Lateral and Z resolutions of ∼1 μm and 0.1 nm, were achieved respectively. Thicknesses were derived from matrices and a Levenberg-Marquardt multivariate regression algorithm to Fresnel equations for multi-layered films.

RESULTS

Ellipsometric measurements of pooled and individual human tears in-vitro revealed a larger overall range (0-500 nm) of surface film thicknesses than previously reported by any one study. Each sample showed thin areas (0-2.6 nm) with interspersed thicker regions (∼200-500 nm). Repeat measurements of a single donor collected at weekly intervals showed a broad range of surface thicknesses within and between samples. Thickness measurements from a dry eye subject overlapped that of normal subjects.

CONCLUSION

The data show that published disparity in surface film thickness may be attributable to limitations of prior methodologies. The range and overlap of surface film thicknesses challenge less rigorous methodologies that claim to segregate normal and dry eye.

Lipidomics of human Meibomian gland secretions: Chemistry, biophysics, and physiological role of Meibomian lipids

Human Meibomian gland secretions (MGS) are a complex mixture of diverse lipids that are produced by Meibomian glands that are located in the upper and the lower eyelids. During blinking, MGS are excreted onto the ocular surface, spread and mix with aqueous tears that are produced by lachrymal glands, and form an outermost part of an ocular structure called "the tear film" (TF). The main physiological role of TF is to protect delicate ocular structures (such as cornea and conjunctiva) from desiccating. Lipids that are produced by Meibomian glands are believed to "seal" the aqueous portion of TF by creating a hydrophobic barrier and, thus, retard evaporation of water from the ocular surface, which enhances the protective properties of TF. As lipids of MGS are interacting with underlying aqueous sublayer of TF, the chemical composition of MGS is critical for maintaining the overall stability of TF. There is a consensus that a small, but important part of Meibomian lipids, namely polar, or amphiphilic lipids, is of especial importance as it forms an intermediate layer between the aqueous layer of TF and its upper (and much thicker) lipid layer formed mostly of very nonpolar lipids, such as wax esters and cholesteryl esters. The purpose of this review is to summarize the current knowledge on the lipidomics of human MGS, including the discussions of the most effective modern analytical techniques, chemical composition of MGS, biophysical properties of Meibomian lipid films, and their relevance for the physiology of TF. Previously published results obtained in numerous laboratories, as well as novel data generated in the author's laboratory, are discussed. It is concluded that despite a substantial progress in the area of Meibomian glands lipidomics, there are large areas of uncertainty that need to be addressed in future experiments.

Tear lipids interfacial rheology: effect of lysozyme and lens care solutions

PURPOSE

To evaluate the interfacial properties of ex vivo tear lipid multilayers with controlled and varying thickness. The influence of lysozyme and surfactant-containing multipurpose lens care solution (MPS) on interfacial rheology of lipids and mixed lipid-protein films were studied.

METHODS

Lipids were extracted from lotrafilcon A lenses worn continuously for 1 month. Interfacial properties of the lipids without and with lysozyme in the aqueous phase were examined using tensiometry and step-strain relaxation. Lipid-lysozyme multilayers were exposed to either diluted opti-free express (OFX) or opti-free replenish (OFR) for 30 min, and then MPS was displaced from the bulk phase. Surface tension and rheological parameters before and after MPS exposure were measured and compared.

RESULTS

Thick lipid films exerted high surface pressure at the air-aqueous interface, 50 +/- 2 mN/m, with little inter- and intrasubject variability. The rheological storage modulus (E(infinity); 25.3 +/- 2 mN/m) and relaxation time (tau; 87 +/- 25 s) were similar among subjects. Neither lysozyme nor MPS changed the surface tension of the lipid multilayers. Lysozyme adsorbed irreversibly onto multilayers without changing E(infinity), but increased tau 2.5 times. Exposure of mixed multilayers to OFX reduced E(infinity) to less than a half of its original value (13 +/- 4.5 mN/m; p < 0.001), whereas after OFR exposure, small but statistically significant changes in E(infinity) were found (21 +/- 3.0 mN/m; p = 0.0044). MPS-treated mixed films relaxed much slower than an untreated one, tau increased 4.5 times after OFX and 7 times after OFR exposure.

CONCLUSIONS

Thick multilayers of the ex vivo tear lipids have exhibited surface tension 15 +/- 1 mN/m lower than reported in the literature for meibomian lipids. The lipid-lysozyme interaction altered the interfacial rheology of the ex vivo lipids. OFX and OFR changed rheological properties of the mixed films to different extents.

Surface pressure measurements of human tears and individual tear film components indicate that proteins are major contributors to the surface pressure

PURPOSE

Tear film stability has been associated with a low surface tension (high surface pressure), which has been attributed to a variety of tear film components. In this study, we examined the contribution of various tear proteins, mucin, and meibomian lipids to the surface pressure of human tears.

METHODS

A Langmuir trough was used to measure and compare the surface activities of albumin, lipocalin, beta-lactoglobulin, lactoferrin, lysozyme, secretory IgA, mucin, meibomian lipid, and tears.

RESULTS

All proteins exhibited surface activity. The surface pressure-area (Pi-A) profiles of most protein films at equilibrium surface pressure (Pieq) were sigmoidal and showed hysteresis between the expansion and compression phases of the cycle. Pieq of most proteins took 4-9 hours to occur. By contrast, the Pi-A profiles for meibomian lipid films were hyperbolic rather than sigmoidal and had little hysteresis, and Pieq was attained within 1 hour. The Pi-A profiles of mucin films showed mostly hyperbolic characteristics with small hysteresis. The Pi-A profiles of films of tears were sigmoidal, showed strong hysteresis, and reached Pieq at about 5 hours. Partitioning of the proteins and whole tears into the subphase also occurred.

CONCLUSION

Comparison between the dynamic Pi-A profiles of tears and those of individual tear film components shows that tear film proteins not only are capable of surface activity but also are major contributors to the surface activity of the tear film.

Tolerability and safety of two new preservative-free tear film substitutes

PURPOSE

The tolerability, safety, and visual comfort of two new tear film substitutes were studied in a phase I clinical study.

METHODS

Two amphipathic lipids (phosphatidylcholine, cholesterol, sphingomyelin, and gangliosides) containing solutions (I and II) of well-defined stoichiometry, free of preservatives, were studied in 20 eyes of 20 healthy volunteers (age range, 26-32 years) in a randomized, double-blind, crossover study. Randomization was achieved by treating one eye of each volunteer four times daily for 7 days with composite solution I. The contralateral eye served as a control. After a washout interval of 7 days, the same eye was treated similarly four times daily with the solution II under randomizing conditions. Slit-lamp biomicroscopy, visual acuity, visual analog scales, and side effects were monitored at the beginning of the study weekly and for 3 weeks.

RESULTS

The tear substitutes proved to have no influence on the visual acuity and were safe and well tolerated. No allergic reactions or any other side effects such as hyperemia, corneal disturbance, and foreign body deposits were observed in any volunteer.

CONCLUSION

The biophysical properties of the amphipathic lipids comprising the two preservative-free tear film substitutes were studied in monolayer experiments. They form reversibly compressible and expandable monomolecular films at the air-water interface, a prerequisite for the mimicry of the tear film produced normally by meibomian glands. The efficacy and safety of both medications will be investigated in patients with keratoconjunctivitis sicca and dry eye syndrome in future experiments.

Biophysical behaviour of the infant Meibomian lipid layer

Infants have been known occasionally to stare without blinking for almost a minute. This puts great demands on the stability of their tear-film. To verify the stability of infant tears, we performed biophysical experiments on Meibomian gland secretion, which forms the outermost layer of the tear-film. The secretion was taken from infants belonging to one of three age-groups (1.5 years, 4-5 years, 7-10 years). Under in vitro conditions we determined the surface pressure and the surface potential of the film by spreading the secretion over a water surface and subsequently compressing and decompressing it. Sufficient amounts of Meibomian gland secretion were expressed in all age-groups. The surface pressure and the surface potential of the tears in infants corresponded to those in healthy adults. It was also found that the younger the patient was, the better was the consistency of the surface potential under repeated periods of compression and expansion. In comparison with the secretion of healthy adults, the infant Meibomian gland secretion showed better biophysical characteristics and a correspondingly higher stability in the tear-film.