Evaluation of Dry Eye After Refractive Surgery According to Preoperative Meibomian Gland Status

Qianwen Gong; Anqi Li; Lin Chen; Huijuan Chen; Jinjing Gu; Zhiqiang Xu; Fan Lu; Liang Hu

doi:10.3389/fmed.2022.833984

Evaluation of Dry Eye After Refractive Surgery According to Preoperative Meibomian Gland Status

Front Med (Lausanne). 2022 Apr 25:9:833984. doi: 10.3389/fmed.2022.833984. eCollection 2022.

Authors

Qianwen Gong^{1

2}, Anqi Li^{1

2}, Lin Chen^{1

2}, Huijuan Chen^{1

2}, Jinjing Gu^{1

2}, Zhiqiang Xu^{1

2}, Fan Lu^{1

2}, Liang Hu^{1

2}

Affiliations

¹ Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
² National Clinical Research Center for Ocular Diseases, Wenzhou, China.

Abstract

Purpose: To investigate the effect of the preoperative meibomian gland (MG) status on dry eye symptoms after corneal refractive surgery.

Methods: This is a prospective, observational study. Subjects were enrolled and classified into 3 groups according to their MG loss grades. Ocular surface parameters were measured preoperatively and at 1, 3, and 6 months, postoperatively, including the ocular surface disease index questionnaire (OSDI), non-invasive tear film break up time (NIBUT), tear meniscus height and Schirmer I test. All the parameters were analyzed among the three groups, and different time points.

Results: Seventy-eight patients were included in this study. The grade of MG loss varied from 0 to 2, thus the subjects were divided into group 1-3 corresponding to the MG loss. There were no significant differences in all parameters at baseline. The OSDI score increased in all groups at 1 month postoperatively and then decreased after other follow-ups. The OSDI was higher in group 3 than group 1 at all time points postoperatively (P = 0.005, 0.002, 0.034). Besides, it was higher in group 2 at 3 months and 6 months, compared with group 1 (P = 0.006, 0.029). The average NIBUT was shorter in group 3, compared with group 1 and group 2 since 1 month after surgery. At 1 and 3 month postoperatively, the grade of MG loss was positively correlated with the total OSDI and the vision-related scores. And it showed a positive correlation only with the environmental score at 6 months postoperatively.

Conclusions: The dry eye discomfortable symptoms significantly differed post operatively according to their preoperative MG loss grade, though no difference was found at baseline. Dry eye was associated more with vision-related discomfort at first and environmental factors later.

Keywords: NIBUT; OSDI questionnaire; corneal refractive surgery; dry eye; meibomian gland.