Issue: May/June 2020
Perspective from Catherine Hogan, OD, FAAO
Disclosures: The authors report no relevant financial disclosures.
May 15, 2020
3 min read
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MGD leads to different dry eye symptoms after cataract surgery

Issue: May/June 2020
Perspective from Catherine Hogan, OD, FAAO
Disclosures: The authors report no relevant financial disclosures.
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An investigation into dry eye symptoms after cataract surgery in patients with meibomian gland dysfunction showed different changes to the ocular surface and damages to the epithelial function between early and late postoperative phases compared with common cataract patients.

“We believed that changes in the early postoperative phase to the ocular surface were caused by surgical factors, and for MGD patients with cataract surgery, changes in the early postoperative phase to the ocular surface were caused by surgical factors, and the damages to epithelial function in the later postoperative phase were mainly associated with the inflammation of the meibomian gland and eyelid; thus, MGD would have aggravated the development of dry eye,” the researchers wrote in the study published in International Ophthalmology.

The researchers divided 115 patients (115 eyes) with age-related cataract into either an MGD diagnosis group or a control group. They performed Schirmer I test (ST-I), tear breakup time (TBUT) and corneal fluorescein staining (CFS) preoperatively and at 3 days, 7 days, 14 days and 30 days postoperatively, along with meibomian gland morphology and expression and meibum character scores.

Postoperative TBUT was shorter than preoperative in both groups (P < .01); however, TBUT was less in the MGD group than the control group (P < .01).

ST-1 results increased at 3 days and 7 days postop in both groups, then decreased gradually at 14 days and 30 days. At 30 days, ST-1 was significantly different compared with preoperative results in both the MGD (10.93 vs. 13.61 mm) and control group (10.15 vs. 12.89 mm). This change was not different between the groups.

CFS scores were higher in the MGD group compared with controls at each time point after surgery (P < .01), although the control group also had significantly increased CFS scores after surgery. Both groups showed decreases by 14 days and 30 days.

The researchers determined that MGD correlated positively with TBUT and CFS results postoperatively (P < .01).

For the patients with MGD, postoperative eyelid margin morphology scores at different times increased significantly with time, the main manifestations of which were increased blood capillary hyperemia of the eyelid margin and aggravated eyelid edge swelling. Results also showed that meibum secretion and meibum characteristic scores increased postoperatively, although these results were not statistically significant.

“Providers should pay attention to the treatment of MGD in patients with dry eye after surgery, except for artificial tears without preservatives and hormone anti-inflammatory treatment,” the researchers concluded. “Before the operation, the patient’s meibomian gland function should be carefully evaluated; the intervention and treatment of MGD may effectively reduce the occurrence of dry eye.” – by Talitha Bennett

Disclosures: The authors report no relevant financial disclosures.