Influence of cataract surgery on Meibomian gland dysfunction [Translation]

J Fr Ophtalmol. 2018 Jun 7. pii: S0181-5512(18)30197-9. doi: 10.1016/j.jfo.2017.11.021.
[Article in French]
El Ameen A, Majzoub S, Vandermeer G, Pisella PJ.

Abstract:

PURPOSE:

To evaluate the influence of cataract surgery on meibomian gland dysfunction, in particular on postoperative functional symptoms.

PATIENTS AND METHODS:

Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break up time [TBUT], corneal staining, meibomian gland expressibility test) and a paraclinical evaluation (loss of Meibomius glands [LMG] measured using ImageJ on meibography, conjunctival redness and non-invasive tear break up time [NIK-BUT]) were performed preoperatively and at 1 month and 3 months after phacoemulsification.

RESULTS:

TBUT and meibomian gland expressibility were worsened at 1 month and 3 months postoperatively (P<0.05). LMG was significantly more important for the upper eyelid and the mean at 1 month (33.1±15.2 P=0.02; 28.5±15.6 P=0.025, respectively) and 3 months postoperatively (36.5±17.4 P=0.0005; 31.2±17.4 P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between LMG on the upper eyelid preoperatively and the OSDI score at 1 month postoperatively (R=0.37; P=0.05).

CONCLUSION:

The meibomian gland loss in the upper eyelid is associated with an increased postoperative ocular discomfort score. Alterations in the meibomian gland expressibility and TBUT persist for up to 3 months postoperatively suggesting a direct role of cataract surgery by an obstructive mechanism.