Analysis of risk factors associated with meibomian gland orifice obstruction severity in glaucoma patients: a clinical investigation.

Purpose: To investigate the synergistic effects of duration of glaucoma and number of medications on meibomian gland orifice obstruction severity in glaucoma patients, aiming to optimize therapeutic strategies for ocular surface protection.

Methods: This retrospective study analyzed 120 glaucoma patients with concurrent MGD. Meibomian gland orifice obstruction was scored using standardized criteria. The relationship between obstruction scores and clinical factors was evaluated using Spearman correlation and generalized linear modeling.

Results: Significant correlations were found between MG orifice obstruction score and duration of glaucoma (r = 0.309, P < 0.001), number of medications (r = 0.340, P < 0.001), number of preserved eye drop products (r = 0.300, P < 0.001) and duration of medication (r = 0.398, P < 0.001). Generalized linear modeling revealed significant main effects of duration of glaucoma and number of medications (P = 0.012 and P = 0.005), with a significant interaction (P = 0.020). After 3 years of glaucoma, any medication regimen significantly increased obstruction scores compared to no treatment (all P < 0.05). Triple or quadruple therapy showed significantly higher obstruction scores versus no medication (P = 0.002 and P = 0.008).

Conclusion: Duration of glaucoma and number of medications synergistically worsen MG orifice obstruction, with a critical threshold after one year of disease. These findings suggest the importance of reducing medication burden in long-term glaucoma patients.