Influence of cataract surgery on Meibomian gland dysfunction

Ameen, Ala El; Majzoub, S.; Vandermeer, G.; Pisella, Pierre‐Jean

doi:10.1016/j.jfo.2018.03.001

Cited by 22 publications

(22 citation statements)

References 30 publications

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“…Functional changes of meibomian glands after surgery have been previously reported in surgeries other than PKP [32][33][34][35][36]. Unavoidable trauma from cataract surgery may induce ocular inflammation [37].…”

Section: Discussionmentioning

confidence: 93%

Changes in ocular surface and Meibomian gland after penetrating Keratoplasty

et al. 2021

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Background To acquire desirable outcomes of penetrating keratoplasty (PKP), various factors affecting graft survival, visual function, and subjective symptom should be considered. As ocular surface and meibomian gland function are associated with these factors, this study aims to investigate changes of ocular surface and meibomian gland parameters after PKP. Methods This retrospective case series study included 24 eyes of 24 patients who underwent penetrating keratoplasty. Examinations on lipid layer thickness (LLT), meiboscore, tear meniscus area (TMA), tear breakup time (TBUT), corneal fluorescein staining (CFS), Schirmer I test (SIT), Ocular Surface Disease Index (OSDI), and meibomian gland functions were performed before and at 1 week, 1 month, 6 months, and 12 months after surgery. Results Compared to baseline (2.9 ± 0.6 s), TBUTs were longer at 1 week (4.4 ± 0.5 s, P = 0.027) and 6 months (4.4 ± 0.5, P = 0.048) after surgery. CFS values improved from baseline (6.5 ± 1.1) to 6 months (3.5 ± 0.6, P = 0.023) and 12 months (3.3 ± 0.7, P = 0.001) after surgery. Meibum quality value worsened at 1 week and 12 months after surgery and meibomian gland expressibility value worsened at 1 week and 6 months after surgery compared to baseline. OSDI scores improved at 6 and 12 months after surgery. Meiboscore showed no change throughout the follow up period. The patients with high preoperative meiboscore had worse meibomian gland expressibility at 6 and 12 months and meibum quality at 6 months postoperatively compared to their baseline and to those of patients with low preoperative meiboscore. Conclusions After penetrating keratoplasty, ocular surface parameters including corneal staining, TBUT, and OSDI significantly improved whereas meibomian gland parameters showed deteriorations, which was marked in patients with high preoperative meiboscore. Thus, perioperative management of MGD is recommended for patients who undergo penetrating keratoplasty, especially in patients with advanced MGD.

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Section: Discussionmentioning

confidence: 93%

Changes in ocular surface and Meibomian gland after penetrating Keratoplasty

et al. 2021

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“… MGD, meibomian gland dysfunction; DED, dry eye disease; DM, diabetic mellitus; w, week(s); m, month(s); N/A, data not available . * Though A. El Ameen et al ( 34 ) and Young Joon Choi et al ( 18 ) mentioned a preoperative meibomian gland loss, their subjective grading scale based on meibomian gland structure area tends to overestimate the dropout ( 44 ). Considering their lack of explicit mentioning of preoperative MGD status, these two studies were categorized as “not mentioned” when referring to preoperative MGD status .…”

Section: Resultsmentioning

confidence: 99%

Dry Eye and Phacoemulsification Cataract Surgery: A Systematic Review and Meta-Analysis

Lü

Zhu

2021

Front. Med.

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Purpose: To evaluate whether dry eye deteriorates after phacoemulsification cataract surgery, and to explore the influential factors.Methods: Studies published before February 2020 indexed on PubMed and the Cochrane Central Register of Controlled Trials were retrieved. A meta-analysis, including meta-regression, a sensitivity analysis, and a subgroup analysis, were performed.Results: Twenty studies with 2,247 eyes were included in the meta-analysis, dry eye-related parameters were investigated preoperatively and 1 month postoperatively. Patients with pre-existing meibomian gland dysfunction (MGD) had worsened subjective symptoms of dry eye (1.31, 95% confidence interval (CI) [0.66, 1.95], P < 0.0001), a reduced tear break-up time (BUT) (−2.27, 95% CI [−2.66, −1.88], P < 0.0001), and a worse corneal fluorescein staining (CFS) score (0.75, 95% CI [0.5, 1.0], P < 0.0001) after phacoemulsification cataract surgery, whereas in the general population, the subjective symptoms score and CFS remained unchanged and BUT decreased slightly after surgery. Patients without diabetes showed significantly reduced total tear secretion after phacoemulsification cataract surgery (−1.25, 95% CI [−1.62, −0.88], P < 0.0001).Conclusion: Dry eye generally remained unchanged 1 month after phacoemulsification cataract surgery. Notably, worsened symptoms and signs of dry eye were observed more frequently in patients with pre-existing MGD. Patients without diabetes were more susceptible to reduced tearing postoperatively.Clinical Trial Registration: Identifier: PERSPERO (2020: CRD42020203316).

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“…11 Alterations in the meibomian gland expressibility and TBUT which persist for up to 3 months postoperatively suggesting a direct role of cataract surgery in causing MGD by an obstructive mechanism. 12 Despite its clinical importance in postoperative dry eye, the cause of MGD has not been investigated sufficiently and remains elusive. Till date no study has been done to evaluate relationship of topical steroid with increase in MGD postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of meibomian gland dysfunction and dry eye in post-cataract surgery patients treated with topical dexamethasone-moxifloxacin versus topical prednisolone-moxifloxacin combination eye drops

Bhargav¹,

Arora²

2020

IJCEO

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Postoperative dry eye and meibomian gland dysfunction (MGD) is common cause of morbidity. Its cause is still elusive and probably multifactorial. Various studies in the past have thrown some light on its mechanism but still we are not able to prevent its occurrence. Till date no study has analyzed the role of topical steroid as one of the factors influencing postoperative MGD and dry eye. Purpose: The aim of this study was to compare the symptoms and signs of MGD and dry eye in postcataract surgery patients treated with topical dexamethasone-moxifloxacin versus topical prednisolonemoxifloxacin combination eye drops. Materials and Methods: Seventy eyes of seventy patients of senile cataract who had no dry eye signs preoperatively, and had undergone uncomplicated phacoemulsification surgery were selected. The patients were divided randomly into two study groups -Group 1 patients were started on dexamethasone sodium phosphate -moxifloxacin hydrochloride and Group 2 patients were started on prednisolone acetate -moxifloxacin hydrochloride combination eye drops postoperatively in a tapering dose for 6 weeks. The data collected by scoring of clinical dry eye signs (corneal staining, TBUT, Schirmer test I and meibomian gland dysfunction assessed by meibum expressibility and meibum quality score) and symptoms scoring by SPEED II questionnaire. The study was done in both the groups preoperatively and at 1 week, 4 weeks and 8 weeks postoperatively. Both the groups were compared using independent paired t-test and Mann -Whitney test. Results: The mean values of SPEED II, TBUT, corneal staining, meibomian gland expressibility, meibum quality were statistically significantly higher in all followup visits (at 1week, 4 weeks, and 8 weeks) in group 2 as compared to group 1.(p<.001). Conclusion:Post cataract surgery patients treated with dexamethasone -moxifloxacin eye drops had statistically significantly lesser symptoms and signs of dry eye and MGD as compared to patients treated with prednisolone-moxifloxacin combination eye drops.

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Influence of cataract surgery on Meibomian gland dysfunction

Cited by 22 publications

References 30 publications

Changes in ocular surface and Meibomian gland after penetrating Keratoplasty

Changes in ocular surface and Meibomian gland after penetrating Keratoplasty

Dry Eye and Phacoemulsification Cataract Surgery: A Systematic Review and Meta-Analysis

Comparative study of meibomian gland dysfunction and dry eye in post-cataract surgery patients treated with topical dexamethasone-moxifloxacin versus topical prednisolone-moxifloxacin combination eye drops

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