Meibomian Gland Dysfunction in Patients Who Underwent Transconjunctival Approach Surgery for Inferior Orbital Wall Fractures

Abstract

Purpose: To investigate whether transconjunctival approach surgery caused meibomian gland dysfunction in patients with inferior orbital wall fractures. Methods: Twenty consecutive patients who underwent reconstruction surgery for unilateral inferior orbital wall fracture via a transconjunctival approach were enrolled in this study. All patients were asked to complete the Ocular Surface Disease Index questionnaire for each separate eyelid. Both eyelids of each patient underwent slit lamp examination to determine the lid margin abnormality scores. The structure of the meibomian gland was assessed using meibography. Intraindividual comparison of outcome measurements between both eyelids was performed using the Wilcoxon signed-rank test. The contralateral eyelid of each patient was used as a normal control. Results: The mean Ocular Surface Disease Index score of the operated eyelid was 46.5 +/- 8.9, which was significantly higher than that of the contralateral normal eyelid (23.4 +/- 7.3; P = 0.02). The lid margin abnormality score of the operated eyelid (1.2 +/- 0.7) was higher than that of the normal eyelid (0.5 +/- 0.7; P = 0.033). The meibography score of the eyelid on the operated side (1.8 +/- 0.8) was greater than that of the contralateral eyelid (1.0 +/- 1.0; P = 0.015). Conclusions: Compared to paired normal eyelids, eyelids that underwent transconjunctival approach surgery exhibited significant signs of meibomian gland dysfunction. Clinicians should be aware of such ocular symptoms in patients after transconjunctival approach surgery.