Postoperative changes in status of meibomian gland dysfunction in patients with involutional entropion

Purpose To examine postoperative changes in the status of meibomian gland dysfunction in patients with involutional entropion. Methods This prospective, interventional study included 10 eyelids of 8 patients with involutional entropion who underwent posterior layer advancement of the lower eyelid retractors and either a lateral tarsal strip or transcanthal canthopexy procedure. The following features were examined for evaluation of meibomian gland dysfunction and dry eye: the presence or absence of eyelid abnormalities (irregular eyelid margin, vascular engorgement, and plugged meibomian gland orifices), Marx line score, meibum expression score, loss of the meibomian glands, A (area) and D (density) scores for corneal fluorescein staining, and tear breakup time. All the measurements were performed before and 6 months after surgical correction of involutional entropion. Results Regarding the findings of meibomian gland dysfunction, irregular eyelid margin, vascular engorgement, and plugged meibomian gland orifices improved only in 1 eyelid of 1 patient ( P = 0.317, P = 1.000, and P = 1.000, respectively) postoperatively. The scores of Marx line, meibum expression, and loss of meibomian glands did not statistically change after surgery ( P = 0.157, P = 0.705, and P = 0.317, respectively). The D score was statistically improved after surgery ( P = 0.046), although the difference between the pre- and postoperative A score was not statistically significant ( P = 0.083). Tear breakup time did not change after surgery ( P = 0.705). Conclusions Our study indicates that meibomian gland dysfunction does not resolve after surgical correction of involutional entropion.