Evaluation of Meibomian Gland Dysfunction Before and After Surgical Correction of Cicatricial Entropion of the Upper Eye Lid

Abstract

Background: The malfunctioning of the meibomian glands (MGD) is one of the most important causes of dry eye. MGD refers to a set of disorders characterised by functional abnormalities of the Meibomian gland. This study's objective was to assess meibomian gland dysfunction before and after surgical correction of cicatricial entropion of the upper eyelid using two distinct techniques: Tarsal fracture technique and anterior lamellar reposition with grey line split technique. Methods: This randomized study included thirty consecutive eyes who were randomly divided into two equal groups according to the surgical technique: group (A) that included cases who underwent tarsal fracture technique and group (B) that included cases who underwent anterior lamellar reposition with gray line split technique. Patients were subjected to complete history taking, Ophthalmic examination, Assessment of the visual acuity (VA), Slit lamp bio-microscopy, Measurement of intraocular pressure (IOP), Posterior segment examination, Assessment of        dry eye. Results: The preoperative TBUT was insignificant between group A and group B (p=0.689). The preoperative meibography was insignificant between the group A and group B (p=0.992). The mean postoperative TBUT after 1month in group A was 8 ± 2.38 seconds while in group B was 8.50 ± 2.72 seconds with no statistically significant difference between the two groups (p=0.596). The mean postoperative meibography (meibomain gland dropout percentage) after 1month in group A was 51.27 ± 15.69 while in group B was 49.85 ± 19.19 with no statistically significant difference between the two groups (p=0.825). Conclusions: Meibomain gland dropout by meibography and TBUT increased postoperatively in both group A and group B but more in group A with no statistically significant difference due to small number of cases. Cicatrcial entropion of upper eye lid can be corrected effectively by two different types of surgery: tarsal fracture technique and anterior lameller reposition. Infrared meibography is a good indicator of diagnosis of MGD.