Meibomian Gland Dysfunction and Its Association With Ocular Discomfort in Patients With Ocular Prosthesis.

Abstract

OBJECTIVE To investigate the effects of ocular prosthesis on meibomian glands and also to identify the role of meibomian gland dysfunction (MGD) on ocular discomfort in prosthetic eyes. METHODS This prospective study included 55 patients who had been wearing unilateral ocular prosthesis for more than 1 year. A 15-item questionnaire regarding MGD-related ocular symptoms was administered to all patients. Both prosthetic eyes and paired normal eyes were evaluated with slit-lamp, noncontact meibography and spectral optical coherence tomography. A multiple linear regression model was applied to evaluate factors on ocular symptom scores. RESULTS The ocular symptom scores, meibography scores, meibomian gland loss, and lid margin abnormality scores of prosthetic eyes were significantly higher than those of normal eyes (P<0.05). Tear meniscus measurements of eyes with prosthesis were significantly lower from those of normal eyes (P<0.05). The ocular symptom scores were significantly positively correlated with meibography scores, meibomin gland loss, and lid margin abnormality scores and negatively correlated with tear meniscus measurements (P<0.05). There was a significant negative correlation between total meibography scores and all tear meniscus parameters (P<0.05). The patients who had used ocular prosthesis for longer durations had a significantly greater meibography scores, meibomin gland loss, lid margin abnormality scores, and ocular symptom scores but lesser tear meniscus parameters (P<0.05). CONCLUSION Use of ocular prosthesis is significantly associated with MGD, which is proportional to the duration of prosthesis wear. Furthermore, ocular discomfort symptoms of prosthetic eye wearers significantly correlated with MGD-related dry eye.