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Filed Under
Refractive
meibomian gland dysfunction
preoperative
ocular surface
2020 paper presentation
Purpose
To report the prevalence of meibomian gland atrophy and gland tortuosity in patients presenting for refractive surgery evaluation.
Methods
Cross-sectional study of consecutive patients presenting for refractive surgery evaluation at the Duke Eye Center from December 2018 through January 2020. All patients had clinical exam and meibography imaging of the lower eyelids bilaterally. Images were graded by a masked rater using a previously validated 5-point meiboscale (0-4) for gland atrophy and 3-point scale for gland tortuosity (0-2).
Results
120 patients (49 male) aged 21 to 62 years (mean 35.2 ±9.2 years) were reviewed. The mean meiboscale was 1.1±1.0 for gland atrophy and 1.0±0.7 for tortuosity. Among all patients, 72.5% (n=87) had any evidence of meibomian gland atrophy (meiboscale >0) and 69.2% (n=83) had any evidence of meibomian gland tortuosity (tortuosity grade >0). The majority of patients (n=52) with gland atrophy had mild gland atrophy (meiboscale =1). The mean meiboscale was 0.89 ±0.79 and 1.38 ±1.07 for the those <35 years and >/= 35 years old, respectively (p=0.01). There was a moderate positive relationship between meiboscale and tortuosity (Pearson correlation 0.3892, Mantel-Haenszel chi-square=17.56, p <0.001).
Conclusion
This study demonstrates meibomian gland atrophy is common in patients presenting for refractive surgery evaluation. Clinicians should consider meibography as part of refractive surgery evaluation, and proactively treat meibomian gland disease given the known association between meibomian gland dysfunction, dry eye, and post-operative outcomes.
To report the prevalence of meibomian gland atrophy and gland tortuosity in patients presenting for refractive surgery evaluation.
Methods
Cross-sectional study of consecutive patients presenting for refractive surgery evaluation at the Duke Eye Center from December 2018 through January 2020. All patients had clinical exam and meibography imaging of the lower eyelids bilaterally. Images were graded by a masked rater using a previously validated 5-point meiboscale (0-4) for gland atrophy and 3-point scale for gland tortuosity (0-2).
Results
120 patients (49 male) aged 21 to 62 years (mean 35.2 ±9.2 years) were reviewed. The mean meiboscale was 1.1±1.0 for gland atrophy and 1.0±0.7 for tortuosity. Among all patients, 72.5% (n=87) had any evidence of meibomian gland atrophy (meiboscale >0) and 69.2% (n=83) had any evidence of meibomian gland tortuosity (tortuosity grade >0). The majority of patients (n=52) with gland atrophy had mild gland atrophy (meiboscale =1). The mean meiboscale was 0.89 ±0.79 and 1.38 ±1.07 for the those <35 years and >/= 35 years old, respectively (p=0.01). There was a moderate positive relationship between meiboscale and tortuosity (Pearson correlation 0.3892, Mantel-Haenszel chi-square=17.56, p <0.001).
Conclusion
This study demonstrates meibomian gland atrophy is common in patients presenting for refractive surgery evaluation. Clinicians should consider meibography as part of refractive surgery evaluation, and proactively treat meibomian gland disease given the known association between meibomian gland dysfunction, dry eye, and post-operative outcomes.
View More Presentations from this Session
This presentation is from the session "SPS-114 Keratorefractive Surgical Planning" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.