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Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction
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Meibomian gland inversion: under-recognized entity.

We Fong Siah1,2, Kostas Boboridis3, Petrina Tan2,4

  • 1Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Acta Ophthalmologica
|June 12, 2019
PubMed
Summary
This summary is machine-generated.

Meibomian gland inversion (MGI) is a subtle eyelid condition often mistaken for dry eye disease. Surgical correction offers favorable outcomes for refractory cases, though dry eye symptoms may persist.

Keywords:
dry eye diseasegrey linelamellar repositionlid marginmeibomian gland dysfunctionmeibomian gland inversion

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Area of Science:

  • Ophthalmology
  • Anatomical Pathology

Background:

  • Meibomian gland dysfunction (MGD) can lead to upper eyelid margin and meibomian gland inversion (MGI).
  • MGI is a subtle condition often overlooked and misattributed to dry eye disease (DED) or MGD alone.

Purpose of the Study:

  • To describe the clinical features of MGI.
  • To evaluate surgical management and outcomes for symptomatic MGI.
  • To differentiate MGI from other eyelid conditions like trichiasis and entropion.

Main Methods:

  • Retrospective analysis of symptomatic MGI cases refractory to conservative management.
  • Surgical intervention for patients showing positive response to the 'cotton-tip test'.
  • Assessment of anatomical correction, symptom resolution, and complications post-surgery.

Main Results:

  • 21 eyelids in 13 patients (mean age 68.5 years) were analyzed.
  • Complete resolution of refractory symptoms including corneal staining, blink discomfort, and pseudo-blepharospasm.
  • Partial improvement in milder symptoms like gritty feeling, sore eye, and watery eye; DED symptoms persisted in 88%.

Conclusions:

  • MGI is an early anatomical change secondary to MGD, preceding cicatricial marginal entropion.
  • Conservative management with lid hygiene is recommended, but surgery benefits refractory cases with positive 'cotton-tip test' response.
  • Surgical intervention provides favorable anatomical and functional outcomes for selected MGI patients.