J Korean Ophthalmol Soc.  2016 Feb;57(2):228-235. 10.3341/jkos.2016.57.2.228.

The Influence of Preoperative Meibomian Gland Disease on Dryness after Cataract Surgery

• Lee JA
• Cho YK

• KMID: 2213663
• DOI: http://doi.org/10.3341/jkos.2016.57.2.228

Abstract

PURPOSE
The aim of this study is to analyze the influence of preoperative meibomian gland disease (MGD) on the postoperative dry eye disease after cataract surgery.
METHODS
100 eyes of 85 patients who had undergone cataract surgery were enrolled. Patients were stratified into three groups by the severity of meibomian gland disease (MGD Grade I, MGD Grade II and MGD Grade III). In each group, we recorded the indexes of dry eye such as Ocular surface disease index, tear breakup time, Schirmer's test and Corneal staining at preoperatively and postoperative week 1, 2, 5, 9. We compared the indexes, preoperatively and postoperatively between three groups.
RESULTS
In comparison of the preoperative indexes between groups, the more severe meibomian gland disease the patients have, the higher Ocular surface disease index and the shorter tear breakup time were observed (p < 0.05). In comparison the preoperative with the postoperative indexes, Ocular surface disease index was higher and tear breakup time was shorter at every postoperative moment in MGD Grade (Gr) II and Gr III. In comparison between MGD groups, MGD Gr III showed higher ocular surface disease index than MGD Gr I and Gr II at every follow up point, and shorter tear breakup time than MGD Gr I and Gr II at preoperative and postoperative week 1 and 9 (p < 0.05).
CONCLUSIONS
The severity of meibomian gland disease which exist preoperatively can affect the aggravation of dry eye disease after cataract surgery. Therefore, the treatment of meibomian gland disease before cataract surgery can be a therapeutic option to prevent aggravation of dry eye after cataract surgery.

Keyword

Cataract surgery; Dry eye; Meibomian gland disease; Ocular surface disease index; Tear breakup time

MeSH Terms

Cataract*
Eye Diseases
Follow-Up Studies
Humans
Meibomian Glands*
Tears

Figure

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  Figure 1. Changes of Ocular surface disease index stratified by Meibomian gland disease severity (Wilcoxon signed rank test, one white star symbol [p < 0.05] and two white star symbols [p < 0.01] inside the bar means the statistical p-value compared with pre-operative Ocular surface disease index; Kruskal Wallis test & Mann Whitney test, one black star symbol [p < 0.05] means the statistical p-value compared between the Ocular surface disease index of two groups stratified by MGD severity at the same point). Preop = preoperative; POD = postoperative day; MGD = meibomian gland disease.

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  Figure 2. Changes of tear breakup time stratified by Meibomian gland disease severity (Wilcoxon signed rank test, one white star symbol [p < 0.05] inside the bar means the statistical p-value compared with preoperative tear Break Up Time; Kruskal Wallis test & Mann Whitney test, one black star symbol [p < 0.05] means the statistical p-value compared between the tear Breakup time of two groups stratified by MGD severity at the same point). Preop = preoperative; POD = postoperative day; MGD = meibomian gland disease.

• 

  Figure 3. Changes of Schirmer's test stratified by Meibomian gland disease severity (Wilcoxon signed rank test, compared with pre-operative Schirmer's test score; Kruskal Wallis test & Mann Whitney test, compared between the Schirmer's test score of two groups stratified by MGD severity at the same point). Preop = preoperative; POD = postoperative day; MGD = meibomian gland disease.

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  Figure 4. Changes of corneal staining stratified by Meibomian gland disease severity (Wilcoxon signed rank test, compared with preoperative Corneal staining score; Kruskal Wallis test & Mann Whitney test, compared between the Corneal staining score of two groups stratified by MGD severity at the same point). Preop = preoperative; POD = postoperative day; MGD = meibomian gland disease.

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