Growth of meibomian gland tissue after intraductal meibomian gland probing in patients with obstructive meibomian gland dysfunction

Br J Ophthalmol. 2018 Jan;102(1):59-68. doi: 10.1136/bjophthalmol-2016-310097. Epub 2017 Jun 7.


Purpose: To investigate the impact of meibomian gland probing (MGP) on meibomian gland (MG) area from the upper lids of patients with obstructive meibomian gland dysfunction (o-MGD).

Methods: Retrospective study comparing pre-MGP/post-MGP non-contact infrared meibography results in patients with o-MGD, viewing signs of MG growth within total measurement field.

Results: Post-MGP meibography of 34 lids (19 patients, ≥4.5 to ≤12 months' follow-up) showed 41.2% with MG growth. Ten lids had meibographies suitable for analysis, showing significant collective (116 glands) increase in mean individual glandular area (MIGA) of 4.87% (p=0.0145). Four of 10 lids independently showed significant increase in MIGA, ranging from 10.70% to 21.13% (p<0.0001, p=0.0277, p=0.0292, p=0.0345), while six did not.At >12 and <25 months' follow-up, 16 lids (9 additional patients) had follow-up showing 25% with signs of MG growth. Analysis of three lids showed a significant collective (33 glands) increase in MIGA of 11.19% (p=0.0004). Two of three lids independently showed significant increase in MIGA of 13.73% and 20.00% (p=0.0097, p=0.0001). Collectively, for all 13 analysed lids (149 glands), there was a significant increase of 6.38% in total glandular area (p=0.0447) and a significant increase of 6.23% in MIGA (p=0.0003).

Conclusion: MGP was associated with increased MG tissue area and growth of atrophied MGs as viewed on meibography. MGP provides unequivocal physical proof of a patent meibum outflow tract through the natural orifice, and may promote glandular growth in part by direct mechanical establishment of a patent duct/orifice system.

Keywords: cornea; eye lids; ocular surface; treatment medical; treatment surgery.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Atrophy
  • Constriction, Pathologic
  • Diagnostic Techniques, Ophthalmological*
  • Disease Progression
  • Eyelid Diseases / diagnosis*
  • Eyelid Diseases / etiology
  • Eyelid Diseases / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meibomian Glands / pathology*
  • Meibomian Glands / surgery
  • Middle Aged
  • Ophthalmologic Surgical Procedures / adverse effects*
  • Postoperative Complications*
  • Punctures / adverse effects
  • Retrospective Studies
  • Time Factors