Meibomian gland inversion: under‐recognized entity
| Autor: | Sheraz M. Daya, Andre Litwin, Petrina Tan, Kostas G. Boboridis, Raman Malhotra, We Fong Siah |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty business.product_category Meibomian gland Ophthalmologic Surgical Procedures Refractory Ptosis medicine Humans Trichiasis Meibomian Gland Dysfunction Aged Retrospective Studies Aged 80 and over Lid margin business.industry Eyelids Meibomian Glands General Medicine Middle Aged medicine.disease eye diseases Surgery Entropion Ophthalmology Treatment Outcome medicine.anatomical_structure Tears Female sense organs Eyelid medicine.symptom Eyelash business Follow-Up Studies |
| Zdroj: | Acta Ophthalmologica. 97 |
| ISSN: | 1755-3768 1755-375X |
| DOI: | 10.1111/aos.14155 |
| Popis: | Objective To describe a clinical entity of upper eyelid margin and meibomian gland inversion (MGI) sequential to meibomian gland dysfunction (MGD), in the absence of eyelash ptosis, trichiasis or manifest marginal entropion. We highlight its clinical features, surgical management and outcomes. Methods We performed a retrospective analysis of symptomatic MGI cases refractory to conservative management who underwent surgery in our centre over a 4-year period. Anatomical correction, resolution of symptoms and possible complications are reported. Results A total of 21 eyelids of 13 patients (mean age: 68.5 ± 15.4, range: 32-88 years) were analysed. Symptomatic MGI patients were operated only if they have noted immediate comfort when we corrected the lid margin position with a cotton tip. Those with refractory superior punctate corneal staining (n = 14 eyes), blink-related discomfort (n = 8) and pseudo-blepharospasm (n = 3) reported complete postoperative resolution. Milder symptoms showed partial improvement: gritty feeling (79%), sore eye (80%) and watery eye (86%). However, symptoms of dry eye disease (DED) persisted in 88% of patients. One case recurred in 6 weeks and was offered revision surgery. Median follow-up was 5 (range: 3-12) months. Conclusion Meibomian gland inversion (MGI) is a subtle clinical entity that can be easily overlooked. Symptoms are often attributed to DED or MGD alone. It is likely that MGI represents early upper lid margin anatomical changes secondary to MGD before cicatricial marginal entropion becomes clinically apparent. Recommended treatment is conservative with intensive lid hygiene and topical MGD management. However, refractory symptomatic cases who respond positively to a 'cotton-tip test' (reversal of lid margin malposition with a rolling cotton-tip) may benefit from surgical intervention with favourable anatomical and functional outcome. |
| Databáze: | OpenAIRE |
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