Influence of cataract surgery on Meibomian gland dysfunction

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 expression test) and a paraclinical evaluation (Meibomian gland loss [MGL] measured using ImageJ on Meibography, conjunctival hyperemia and non-invasive keratograph break-up time [NIK-BUT]) were performed preoperatively and at 1month and 3months after phacoemulsification.

Results: TBUT and Meibomian gland expressibility were worsened at 1month and 3months postoperatively (P<0.05). MGL was significantly higher for the upper eyelid and the mean at 1month (33.1±15.2, P=0.02; 28.5±15.6, P=0.025, respectively) and 3months 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 MGL on the upper eyelid preoperatively and the OSDI score at 1month postoperatively (R=0.37; P=0.05).

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

Keywords: Cataract surgery; Dry eye syndrome; Meibography; Meibomian expressibility; Meibomian gland dysfunction.