The Influence of Chalazion History on Meibomian Gland Loss and DED

To investigate the impact of chalazion history on meibomian gland loss and dry eye disease (DED).

This study was a retrospective case-control study. Sixty patients with a history of chalazion admitted to a certain hospital from June 2021 to June 2024, who were selected as the previous chalazion group, and another 90 patients with no previous history of chalazion who visited the outpatient clinic consecutively during the same period were selected as the nonchalazion group. Comprehensive ocular surface parameters were compared between groups to evaluate long-term meibomian gland loss and DED. The chalazion group was further divided into MG loss (n = 42) and non-MG loss (n = 18) subgroups based on glandular loss status. Logistic regression analyzed factors influencing meibomian gland loss. The MG loss subgroup was stratified by severity into mild-moderate (< 1/3 or 1/3-2/3 loss) and severe (> 2/3 loss) groups for comparison of parameters of DED (Schirmer's test, tear break-up time [BUT], and fluorescein staining [FL]). Pearson's correlation assessed the relationship between meibomian gland loss severity and DED manifestations.

Significant differences were observed between the chalazion and nonchalazion groups in tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). The MG loss subgroup indicated statistically significant differences from the non-MG loss subgroup in chalazion recurrence frequency, surgical history, tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). All differential indicators demonstrated no collinearity (VIF ≤ 10, tolerance ≥ 0.1). Logistic regression identified chalazion recurrence frequency and surgical history as independent risk factors for meibomian gland loss. Pearson's analysis revealed negative correlations between meibomian gland loss severity and both Schirmer's test results (r1 = -0.761) and BUT (r2 = -0.543), and a positive correlation with FL scores (r3 = 0.752) (all p < 0.05).

Retrospective analysis revealed that a proportion of patients with meibomian gland loss had prior chalazion history, demonstrating distinct ocular surface characteristics compared to nonchalazion patients. Recurrent chalazion episodes and surgical history were identified as significant contributors to meibomian gland loss, with glandular loss severity showing strong correlations with DED clinical parameters. These findings highlight the substantial impact of recurrent chalazion and surgical interventions on meibomian gland dysfunction and DED development, emphasizing the need for early clinical recognition and proactive management.