Meibomian Gland Dysfunction and Its Association With Ocular Discomfort in Patients With Ocular Prosthesis.

Objective: To investigate the effects of ocular prosthesis on meibomian glands and also to identify the role of meibomian gland dysfunction (MGD) on ocular discomfort in prosthetic eyes.

Methods: This prospective study included 55 patients who had been wearing unilateral ocular prosthesis for more than 1 year. A 15-item questionnaire regarding MGD-related ocular symptoms was administered to all patients. Both prosthetic eyes and paired normal eyes were evaluated with slit-lamp, noncontact meibography and spectral optical coherence tomography. A multiple linear regression model was applied to evaluate factors on ocular symptom scores.

Results: The ocular symptom scores, meibography scores, meibomian gland loss, and lid margin abnormality scores of prosthetic eyes were significantly higher than those of normal eyes (P<0.05). Tear meniscus measurements of eyes with prosthesis were significantly lower from those of normal eyes (P<0.05). The ocular symptom scores were significantly positively correlated with meibography scores, meibomin gland loss, and lid margin abnormality scores and negatively correlated with tear meniscus measurements (P<0.05). There was a significant negative correlation between total meibography scores and all tear meniscus parameters (P<0.05). The patients who had used ocular prosthesis for longer durations had a significantly greater meibography scores, meibomin gland loss, lid margin abnormality scores, and ocular symptom scores but lesser tear meniscus parameters (P<0.05).

Conclusion: Use of ocular prosthesis is significantly associated with MGD, which is proportional to the duration of prosthesis wear. Furthermore, ocular discomfort symptoms of prosthetic eye wearers significantly correlated with MGD-related dry eye.