View 2019 Abstracts

Title Can upper lid everting surgery improve dry eye symptoms in patients with Meibomian gland inversion not responding to treatment?
Submitted by Emma Samia-Aly
Abstract Number 103
Review Result rapid fire presentation
Purpose

A case series of patients who underwent surgical treatment for Meibomian gland inversion (posterior migration of the meibomian gland orifice, MGI) in the upper lid, secondary to cicatricial Meibomian gland disease not responding to maximal medical management.

Methods

This was a retrospective, non-comparative, interventional case series of all patients who underwent an upper eyelid everting surgery with placement of everting sutures through a skin crease incision between July 2017 and Jan 2019. The surgical and functional outcomes are discussed including symptoms, meibomian gland position, extent of ocular surface disease and duration and type of medical treatment preceding surgery.

Results

7 eyes of 5 patients were included in the study. All patients had been referred from cornea clinic, where various medical therapies, including lubricants, topical steroid and cyclosporin, lid hygiene, oral doxycycline, and a bandage contact lens trial, in some cases, were tried. All patients had persistent symptoms and superior ocular surface staining secondary to MGI. On average patients were treated for 7.5 months before referral, with one patient being referred 11 years after her initial consultation. Following surgery meibomian gland eversion was achieved in all eyes (100%). 85% of eyes had symptomatic improvement and 100% had improved superior ocular surface staining at follow up.

Conclusion

A simple upper lid everting surgery can be effective in managing patients with MGI giving them symptomatic relief when all medical treatment fail. To the best of our knowledge, this is the first case series describing this simple surgical technique in the management of MGI.


Additional Authors
Last name Initials City / Hospital Department
Patel R University Hospital Coventry Ophthalmology
Barua A University Hospital Coventry Ophthalmology
Mehta P University Hospital Coventry Ophthalmology