Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.
Int Ophthalmol. 2020 Jun;40(6):1397-1402. doi: 10.1007/s10792-020-01305-8. Epub 2020 Feb 15.
To examine postoperative changes in the status of meibomian gland dysfunction in patients with involutional entropion.
This prospective, interventional study included 10 eyelids of 8 patients with involutional entropion who underwent posterior layer advancement of the lower eyelid retractors and either a lateral tarsal strip or transcanthal canthopexy procedure. The following features were examined for evaluation of meibomian gland dysfunction and dry eye: the presence or absence of eyelid abnormalities (irregular eyelid margin, vascular engorgement, and plugged meibomian gland orifices), Marx line score, meibum expression score, loss of the meibomian glands, A (area) and D (density) scores for corneal fluorescein staining, and tear breakup time. All the measurements were performed before and 6 months after surgical correction of involutional entropion.
Regarding the findings of meibomian gland dysfunction, irregular eyelid margin, vascular engorgement, and plugged meibomian gland orifices improved only in 1 eyelid of 1 patient (P = 0.317, P = 1.000, and P = 1.000, respectively) postoperatively. The scores of Marx line, meibum expression, and loss of meibomian glands did not statistically change after surgery (P = 0.157, P = 0.705, and P = 0.317, respectively). The D score was statistically improved after surgery (P = 0.046), although the difference between the pre- and postoperative A score was not statistically significant (P = 0.083). Tear breakup time did not change after surgery (P = 0.705).
Our study indicates that meibomian gland dysfunction does not resolve after surgical correction of involutional entropion.
研究退行性下睑内翻患者术后睑板腺功能障碍的变化。
本前瞻性、干预性研究纳入了 8 例退行性下睑内翻患者的 10 只眼睑，这些患者均接受了下睑缩肌后层推进术，并且接受了外侧睑板条或经皮睑缘固定术。检查了以下特征以评估睑板腺功能障碍和干眼症：眼睑异常（不规则睑缘、血管充血和睑板腺开口堵塞）、Marx 线评分、睑脂分泌评分、睑板腺缺失、角膜荧光素染色的 A（面积）和 D（密度）评分、泪膜破裂时间。所有测量均在退行性下睑内翻手术矫正前和术后 6 个月进行。
关于睑板腺功能障碍的发现，只有 1 例患者的 1 只眼睑的不规则睑缘、血管充血和睑板腺开口堵塞得到改善（P=0.317、P=1.000 和 P=1.000）。术后 Marx 线、睑脂分泌和睑板腺缺失评分无统计学变化（P=0.157、P=0.705 和 P=0.317）。尽管术后 A 评分的差异无统计学意义（P=0.083），但 D 评分有统计学改善（P=0.046）。术后泪膜破裂时间无变化（P=0.705）。
我们的研究表明，退行性下睑内翻手术矫正后睑板腺功能障碍并未得到解决。
