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Asymptomatic Meibomian Gland Dysfunction in Refractive Surgery Candidates.

Shawn Sapir1, Michael Mimouni2,3, Tzahi Sela2

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Summary

Asymptomatic meibomian gland dysfunction (MGD) in refractive surgery candidates is linked to older age, contact lens wear, higher myopia, and thinner corneas. Routine screening for MGD is advised even without symptoms before refractive surgery.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Ocular Surface Disease

Background:

  • Meibomian gland dysfunction (MGD) can affect ocular surface health.
  • Preoperative assessment for refractive surgery typically focuses on visual acuity and refractive error.
  • The presence of asymptomatic MGD may impact surgical outcomes.

Purpose of the Study:

  • To investigate the association between asymptomatic meibomian gland dysfunction (MGD) and preoperative clinical parameters in candidates for refractive surgery.
  • To identify factors associated with high MGD severity in patients undergoing evaluation for keratorefractive surgery.
  • To assess the impact of MGD on functional visual performance, such as contrast acuity.

Main Methods:

  • Retrospective case-control study of 3,472 eyes undergoing refractive surgery.
  • MGD severity graded clinically (0-3) and categorized as low (0-1) or high (2-3).
  • Univariate and multivariate logistic regression analyses used to identify independent associations with high MGD, including subgroup analysis of contrast acuity.

Main Results:

  • High MGD was present in 49.9% of eyes.
  • High MGD was independently associated with older age, contact lens wear, higher myopia, thinner corneas, and reduced corrected distance visual acuity (CDVA).
  • Reduced contrast acuity was observed in the high MGD group.

Conclusions:

  • Asymptomatic MGD in refractive surgery candidates is independently associated with several preoperative clinical factors.
  • These factors include older age, contact lens wear, higher myopia, thinner corneas, and reduced visual performance.
  • Routine MGD screening is recommended for all patients undergoing preoperative refractive evaluation, regardless of symptoms.